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CAMBEIDGE 



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PRESENTED BY 

MORRILL WVMAN, M. D. 

OF CAMBRIDGE, MASS. 



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PROPERTY OP THE CAMBRIDGE PUBLIC LIBRARY 
Deposited in the Boston Medical Library ' 
by order of the Irustcefi. 



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APR 2S1904 







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in the Francis A. Countway 
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in 2011 with funding from 

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THE 



,/^ 



ANATOMY 

OF THE 

HUMAN BODY. 



BY 

W. C H E S E L DEN, 

Surgeon to his lAs^^^kTf^Eoya/Ifos/?/'/^/ at Chex. sea 
Eello^\^of theKoTAT. Societtt 
And Member of 
The Ei?m/Ara^'m)r(yl*^r//^e/7//.r?x^AKi^ 

THE VtFeDITION 

T^thEoRTY CoPPElLpXiATES 

ILngravd by 6re/ :• Vh/it^rrg^^/c^t. 




LONDON. 

Primed forCHlTCH & R-.DODSLEY 



T O 

Dr. Kichard Mead, 

Phyfician to the Kin g, 

Fellow of the College of 

Phyficians in London, 



And of the 




Royal Society. 



SIR, 
VERY part of Physick 
may juiLly prefume on Your 
protection, to whom it owes fo 
much improvement. Anatomy 
in particular has received fuch ad- 
vantage from Your Lectures, 
that it were a kind of injuftice not 
to dedicate all endeavours in that 
way to You ; in me indeed it v^'ould 
be unpardonable not to offer the 

a fruits 



DEDICATION. 

fruits of thofe ftudies, which at 
firft began, and have ftill been car- 
ried on with Your encouragement. 
The kind reception my induftry 
has met with, is owing to You, the 
authority of whole opinion has in 
every place fecured me fo much fa- 
vour j efpecially in that feat of 
learning, v/hich with diftinguifhed 
honours rewarded Your merit. 
I am, 

5 / i?, 

Tour mofl obliged and 
obedient humble Servant, 



William Cheselden. 



PREFACE. 

THEJtiidy of Anatomy as it leads to the 
knowledge of nature and the art of healings 
needs not many tedious defcripttons nor minute dijfec- 
tions ', what is mojl worth knowing isfooneji learn' d^ 
and leaft the fubjedl of difputes 5 while dividing 
and defcribing the parts^ more than the knowledge of 
their ufes requires^ perplexes the learner^ and makes 
the fcience dry ^ and difficult. 

This edition is a tenth part larger than the for- 
mer^ not encreafed by defcriptions but by obfervations 
upon the ifes and mechanifm oj the parts ^ with ope- 
rations and cafes infurgery, 

HUE plates are more in number^ larger^ better 
defignedy and better executed than thofe which were 
in the former editions^ which has unavoidably en- 
hanced the price of this, 

THEfrontifpiece reprefe72ts thejlory c/ Hippo- 
crates going to cure Democrates of inadnefs^ 
but finding him dife^iing^ to difcover the feat of the 
Bile, he pronounced him the wijefl man in Abdera. 

THE print in the title page reprefents a per f on 
drawing in a Camera obfcura^ fiich a one as wa% 
ufed in this work. 



CON- 



CONTENTS. 

BOOK I. 

^T^ii/E^^;.vr^//;//r^^^^/(?» page i 

IntroduEiion to the hones, 4 

Chap. I. Of the futures and hones of the cranium 1 1 

Chap. 11. Of the hones of the face ^ i£c. 17 

Chap. III. Of the hones of the trunk 21 

Chap. IV. Of the hones of the upper limhs 29 

Chap. V. Of the hones of the lower limhs 34 

Chap. VI. Of the cartilages 41 
Chap. VII. Of the ligaments ibid. 
Chap. VIII. Of the lubricating- glands of the joints 47 

B O O K II. 

Chap. I. 'YNtrodu5fion to the mufcles page 61 

Chap. II. Of the mufcles. 67 

BOOK III. 

Chap. I. f^^ ^^^^ external parts^ and common iniegu^ 
V-/ ments page 133 

Chap .II. Of the membranes in gcncrd 141 

Chap. III. Of the falivary glands 142 

Chap. IV. Of the Peritcneiim^ Omentum, Bumis Alt- 
mentalis^ and Mefentery 14^ 

Chap* 



CO NT E N T S. 

Chap. V. Of the liver, gall-bladder, pancreas, and 
fpleen i6i 

Chap. VI. Of the Vafa La^ea 1 68 

Chap. VII. Of the Pleura, Mediafiinum, Lungs, Peri- 
cardium and Heart 172 
Chap. VIII. Of the arteries and veins 183 
Chap. X. Of the lymphadu^s 209 
Chap. XI. Of the lymphatic glands 212 
Chap. XII. Of the courfe cf the aliment ahftraHedfrom 
the foregoing chapters 216 
Chap. XIII. Of the Dura Mater and Pia Mater 218 
Chap. XIV. Of the Cerebrum, Cerebellum, Medulla Ob* 
longata, and Medulla Spinalis 224 
Chap, XV. Of the nerves 225 

BOOK IV. 

Chap. I. /^^F the urinary and genital parts of men, 
V-^ together with the Glandule Renales 

page 259 
Chap. II. Of the genital parts of women 272 

Chap, III. Of the Fcetus in Utero 278 

Chap. IV. Of the eye, 290 

Chap. V. Of the ear 304 

Chap. VI. Of the fenfes of fmelling, tafling, and feel- 
ing - 310 
Chap. VII. Of cutting for thefione 325 



Adver-^ 



Advertifement. 

SINCE the lafl edition of this book, I have 
publiftied fome Obfervations and cafes in fur- 
gery, with prints of operations and a fet of 
chirurgical inftruments. Thefe are annexed to a 
tranflation of Le Dran's Operations by Mr. 
GatakeR) and as fome of them relate to my 
Anatomy, I thought it proper to take notice of them 
iiere : at the fame time, in juftice to the merit of 
Mr, Le Dran^ I would recommend a careful 
perufal of his book to all praftitioners in furgery. 

W. CHESELDEN. 



THE 



ANATO M Y 



O F T H E 



Human Body, 



T'he General IntroduBion. 

IT is a received opinion, that an animal body is , 
a compages of veffels, varioufly difpofed, to " 
form parts of different figures, for different 
ufes. The ancients fuppofed that the heart and 
brain were firft formed, and that the other parts 
proceeded from them, and that the membranes 
were derived from the dura mater, or pia mater 
of the brain. They diftinguiflied all the parts 
into fpermatic and fanguineous ; the former of 
which they derived from the brain, and the lat- 
ter from the heart ; and frequently engaged in 
difputes about the derivation of parts 3 with many 
other things of the> like nature, confequences of 
their hypothefes. But the moderns, by the affift- 

A snce 



2 GENERAL INTRODUCTION. 

ance of glalTes, having made more accurate obfer- 
vations, conclude, that all the parts exift in minia- 
ture, from the firft formation of the foetus ; and 
that their increafe is only the extenfion and thick- 
nlng of their veffels, and that no part owes its ex- 
iftence to another. Thus much I thought neceffary 
to premife, that the reader might fee for what 
reafon no notice is taken in this treatife of fome 
diflindions and divifions of parts, ufed by ancient 
anatomills, and thofe who have copied after them. 

The conftituent parts of the animal body, are, 
fibres, membranes, arteries, veins, lymphaeduds, 
nerves, glands, excretory veffels, mufcles, tendons, 
ligaments, cartilages, and bones -, to thefe may be 
added the hair and nails. 

Fibres, as they appear to the naked eye, are 
fim.ple threads of the minuteft blood veffels or 
nerves, or both. 

Membranes are compages of fibres, expanded 
to cover, or line any other part. 

Arteries are tubes that arife from the ven- 
tricles of the heart, and thence dividing into bran- 
ches, diffribute the blood to every part of the body. 

Veins are tubes to colledl and return the blood 
from the extremities of the arteries to the heart. 

Lymph^ducts are fine pellucid tubes, to 
carry lymph from all parts, efpecially the glands, 
Vv^hich they difcharge into the larger veins, and in- 
to the vafa ladlea. 

Nerves are fafciculi of cylindrical fibres, which 

arife 



GENERAL INTRODUCTION. 3 

arife from the medulla oblongata of the brain, and 
the medulla fpinalis, and terminate in all the fen- 
fitive parts. They are the immediate organs of fen- 
fation. 

A Gland fecretory, Is compofed of an artery, 
vein, lymphatic, excretory dudt, and nerve. The 
ufe of glands is to fecrete fluids from the blood for 
divers ufes. 

Excretory Vessels are either tubes from 
glands to convey the fecreted fluids to their refpe- 
dive places ; or vefTels from the fmall guts, to carry 
the chyle to the blood veffels -, thefe lafl: are called 
vafa lacflea. 

Muscles are diftindl portions of flefh, which, 
by contrading, perform the motions of the body. 

Tendons are the fame fibres of which the 
mufcles are compofed ; but more clofely conneded, 
that they may poflefs lefs fpace in a limb, and 
be inferted in lefs room into a bone. 

Ligaments are ftrong membranes, or bodies 
of fibres clofely united, either to bind down the 
tendons, or give origin to the mufcles, or tie toge- 
ther fuch bones as have motion. 

Cartilages are hard, elaftic bodies, fmooth 
and infenfibie : Their ufe is to cover the ends of 
the bones that have motion, to prevent their attri- 
tion, &c. 

Bones are firm parts to fuftain, and give il::aps 
to the body, See. 

A2 INTRO. 



[4] 

INTRODUCTION 

TO THE BONES. 

/^^""H*^ H E ufe of the bones is to give fhape and 
i firmneis to the body, to be levers for the 
-^ mufcles to ad upon, and to defend thofe 
parts from external injuries that are of greateft con- 
fequence to be preferved ; as the brain, fpinal mar- 
row, heart, &c. Their fibres when firft formed, 
like the (hells and flones of fruits, are very foft, 
until by the addition of a matter, which is fecreted 
into them, they grow by degrees to the hardnefs 
of a cartilage, and then perfedl bone : Bat this 
change is neidier made in a very (liort time, nor 
begun in all the parts of the fame bone at once. 
Fiat bones, that have their fibres direded to all fides, 
begin to offify in or near a middle point -, but the 
cylindrical bones, and all others whofe fibres are 
nearly parallel, begin about the middle of each fi- 
bre, and thence fhoot forth to their extremities ; 
not alvs^ays in continued lines, but frequently begin- 
ning new ofllfications, which foon join the former ; 
and by the continual addition of this ofljfying mat- 
ter, the bones increafe till their hardnefs refifls a 
farther extenfions and their hardnefs always increaf- 
ing while they are growing, the increafe of their 
growth becomes fiower and flower^ until they ceafe 

to 



I N T R O D U C T I O N, &c. 5 

to grow at all. In old and confumptiFe perfons, and 
fometimes in difeafed or wounded limbs, they de- 
creafe as well as the flefliy parts, though not fo fail, 
becaufe of their hardnefs. Sometimes the offifying 
matter flows out of the bones, and forms bony ex- 
crefcencies 5 and frequently in very old men it fixes 
on the arteries, and makes them grow bony ; and 
when this happens to a degree, the arteries lofe 
their power to propel the blood, until the extreme 
parts mortify. And though the cartilages and arte- 
ries are moil fubjed: to theie changes, yet no part 
is fecure from them ; for I have feen a large part 
of the mufcular fibres of the heart itfelf perfedly 
oilified. I have known one in{l:ance of a deficien- 
cy of this oififying matter, in the lower jaw of an 
adult body ; where all that part on one fide, which 
is beyond the teeth, was of a fubilance between 
that of a cartilage and a ligament. In children that 
have died of the rickets, I have found the nodes on 
the bones foft, fpongy, and bloody, and in one 
fubjedl feveral of them as limber as leather, and the 
perioileum in fome places many times its natural 
thicknefs ; but the cartilages and cartilaginous epi- 
phyfes had no apparent alteration in their texture, 
though fome were fwelled to more than twice their 
natural diameters. 

Every cylindrical bone has a large rniddle 
cavity, which contains an oily marrow, and a 
great number of leiTer cells towards their extre- 
mities, which contain a bloody marrow. The 

bloody 



6 INTRODUCTION. 

bloody marrow is alfo found in all fpongy cells of 
bones. The ufe of the firft kind of marrow, 
I imagine, is to foften, and render lefs brittle, the 
harder fibres of bones near which it is feated ; 
and that the other marrow is of the fame ufe 
to the lefs compadl fibres, which the more oily 
marrow might have made too foft -, and that for 
this reafon, there is lefs of the oily marrow, and 
more of the bloody in young bones than in old 
ones. Every one of thefe cells is lined with a fine 
membrane, and the marrow in the larger cells is 
alfo contained in thin membranous veficles ; in 
, which membranes the vellels are fpread, which en- 
ter obliquely, about the middle of the cylindrical 
bones, from fome of whofe branches the marrow 
is fecreted, while others of them enter the internal 
fubftance of the bones for their nourifhment 5 and 
the reafon why they enter obliquely is, that they 
may not weaken the bones by dividing too many 
fibres in the fame place. If the bones had been 
formed of the fame quantity of matter without any 
cavities, they would, if they were ftreight, be able 
to fuftain the fame weight : But being made hollow, 
their ftrength to refift breaking tranfverfly is en- 
creafed as much as their diameters are encreafed, 
w^ithout encreafing their weights i which mechanifm 
being yet m.ore convenient for birds, the bones of 
their wings, and for the fame reafon their quills, 
have very large cavities, B'^t the bones in the legs 
of all aniiriais are more folid, being formed to fup- 

port 



TOTHEBONES. 7 

port weight ; and mens bodies being fupported by 
two limbs, the bones of thofe limbs are therefore 
made more folid than thofe of quadrupeds. In- 
fedls and moft of the fmalleft animals, have fliells 
inftead of bones, hkelobders, which ferve them alfo 
for defence i and the mufcles being inferred into 
the {hells at a greater diftance from the center of 
motion of each joint than in animals that have 
bones, their motions are neceffarily flower, ftronger 
and more fimple. Therefore in this fort of animals, 
quicknefs of motion, where it is wanted, is pro- 
cured by a number of joints, as may be feen in the 
legs of a flea 5 and variety of m^otions by joints 
with different diredtions, as may be obferved in a 
lobfter. In a fradured bone, in which the fame 
kind of matter that oflified the bones at firfl is 
thrown out from the broken ends of a bone, there 
is formed a mafs of callous matter, of equal foli- 
dity with any part of the bone, and of equal or 
greater diameter, which will make the flrength of 
the bone in that place greater than it was before 5 
w^hich is very convenient, for bones, when broke, 
are feldom or never fet in fo good a direction as 
that in v^hich they were firii formed, and there- 
fore they would be more liable to be broke in the 
fame place again, and would be reunited with great- 
er difficulty, and fometimes not at all, becaufe the 
callus being lefs vafcular than a bone, it does not 
fo eafily admit the offific matter to flow through it 
to form a new callus, 

A 4 Bones 



8 INTRODUCTION 

Bones that are without motion, as thofe of the 
fcull, the offa innominata, &c. alfo bones with 
their epiphyfes, when they meet, prefs into each 
other, and form futures, which foon difappear in 
thofe that join, while their offific matter is foft ^ 
but thofe that grow harder before they meet, prefs 
raore rudely into each other, and make more un- 
even futures, fome of which in the fcull endure to 
the greatefl age : And fometimes while a bone is 
oflifying fi'om its center, a diftant part begins a new 
offiiication and forms a diftindl bone, which may 
happen to be of any figure, Thefe bones are often- 
eft found in the lambdoidal future, and are there 

called offa triauetra. But the ends or fides of bones 

J. , 

that are intended for motion, are hindered from 
uniting/ by the cartilages which cover them; for 
when thefe cartilages are eroded, the bones very rea- 
dily unite, and form an anchylofis. 

The ends of all the bones that are articulated 
for very manifeft motions, or that are not placed 
againft other bones 5 are tipped wirh epiphyfes, or 
additional bones; which in fome meafure deter- 
mine their growth and figure -, for if they had no- 
thing to give bounds to them, they would (hoot 
out like the callus from the broken ends of a bone 
that is ill fet, and grow as ragged as the edges of 
bones which are joined by futures ; and fometimes 
epiphyfes are made ufe of to raife proceffes upon 
bones for the infer tions of mufcles, as the trochan- 
ters of the thigh bones^ where it would weaken 

the 



TOTHEBONES. 9 

the bones too much to have proceffes raifed out of 
their fubftance. 

The fibres of bones, for ought that we can dif- 
cover from experiments or microfcopical obferva- 
tions, appear to conneded to each other by the 
fame means that the parts of a fibre are conned:ed, 
that is, by the ftrong attradion which belongs to 
particles of matter in contadl ; but this cohefion of 
fibre to fibre is not equal to that in the parts of a 
fibre, though very nearly. Indeed, if it was, a 
bone would not be a ftrudure of fibres, but one 
uniform mafs, Hke that of any pure metal, the co- 
hefion of the parts of which are every where alike. 
Nor are the parts of bones difpofed into vifible la- 
mellae, flratum fuper firatum; as many have paint- 
ed ; for though young bones may in fome places 
be fplit into lamellae, yet they not only appear one 
folid uniform mafs to the naked eye, but even with 
a microfcope, till we come to their inner fpongy 
texture, which alfo appears uniform. Their tex- 
ture, when firil formed, is every where loofe and 
fpongy ; but as they increafe, they become in ma- 
ny places very compact and denfe, which refults in 
great meafure from the prefTure of the bellies of 
the mufcles, and other incumbent parts ^ as ap- 
pears from the imprelnons they make on the fur- 
faces of the bones, and the rough fpines that rife 
on the bones in the interfiices of the mufcles, which 
are very remarkable in men who have been bred 
up in hard labour. In thofe parts of the flat bones 

that 



lo I N T R O D U C T I O N, &c. 

that receive but little preflbre, the outer laminag on- 
ly become compadl and denfe, while the middle 
part remains fpongy ; but where the preffure is 
greater, as on the fcapula, and the middle of the 
ilium, they become, in an adult, one denfe body or 
table, and are ufually thinner in thofe places than 
in a child before it is born. The cylindrical or 
round bones, being prefTed moil in their middles, 
become there very hard and ftrong, while their ex- 
tremities remain fpongy, and dilate into large heads, 
which make ftronger joints, and give more room 
for the origins and infertions of the mufcles 5 and 
increafe the power of the mufcles, by removing 
their axis farther from the centre of motion of any 
joint they move. 

All the bones, except fo much of the teeth as 
are out of the fockets, and thofe parts of other 
bones, which are covered with cartilages, or where 
mufcles or ligaments arife or are inferted, are co- 
vered v^^ith a fine membrane, which upon the fcull 
is called pericranium, elfevvhere periofleum. It 
ferves for the mufcles to fiide eafy upon, and to 
hinder them from being lacerated by the roughnefs 
and hardnefs of the boneSc It is every where fall of 
fmall blood veffels, which enter the bones for their 
nourifliment ; but the internal fubftance of the lar- 
ger bones is nouii(hed by the veffels, which enter 
obliquely through their middles, as has been before 
obferved, 

CHAPTER 



(II) 

C H A P T E R I. 

Sutures and bones of the cranium. , 

AS U T U RE is made by the mutual indenta- 
tion of one bone with another. Thofe which 
have proper names are here defcribed ^ thofe which 
have not, derive their names from the bones they 
furround, and are known by them. 

SuTURA coRONALis runs acrofs the fcull, from 
one upper edge of the fphenoidal bone to the other, 
and joins the parietal bones to the frontal. 

SuTuRASAGiTTALis joins the parietal bones ; 
begins at the os cccipitis, and is continued to the 
OS frontis, in children down to the nofe ; the os 
frontis in them being two bones, and fometimes fo 
in adult bodies. 

SuTURA LAMBDoiDALis joius the back part 
of the offa bregmatis, or parietal bones, to the upper 
part of the occipital : In this future are frequently 
obferved fmall bones called offa triquetra, and fome- 
times in other futures. 

SuTURA SQUAMOSA IS made by the upper 
part of the temporal and fphenoidal bones wrapping 
over the lower edges of the parietal bones. 

SuTURA TRANSVERSALis ruus acrofs the 
face, through the bottoms of the orbits of the eyes ; 
it joins the lower edge of the frontal bone to the 
OS fphenoides, maxillae fuperioris, offa nafi, ungues, 
plana, palati, and jugalia, or malarum. 

The 



12 SUTURES AND BONES 

The fcull being divided into many bones, is nei- 
ther fo fubjed: to fradtures, nor to have fradures fo 
far extended, as it v^ould have been wgvq it com- 
pofed of one bone only. This ftrudture is alfo con- 
venient for the offification of the bones, as has been 
already fhewn, and for the birth; becaufe thefe 
bones not being perfed at that time, may be pref- 
fed together, and make the head lefs. 

Ten of the bones of the head compofe the cra- 
nium, to contain the brain and defend it from ex- 
ternal injuries. 

OSSA PARIETALIA Or BREGMATIS are tWO 

large bones which compofe the fuperior and lateral 
parts of the fcull ; on the iniide they are remarka- 
bly imprinted by the arteries of the dura mater, 

O s FRON T IS makes the upper and fore part of the 
cranium ; its lower parts compofe the upper parts 
of the orbits of the eyes, where on its inlides are 
imprefled the volvuli of the brain, v^hich uneven- 
neffes help to keep that part of the brain fteddy. 
In its middle above the os ethmoides ufually arifes 
a thin fpine, which ftrengthens that part of the 
bone, it being ctherwife weak from its flatnefs. In 
fome fculls this fpine is wanting ^ but then the bone 
is ufually thicker in that place, and from its mid- 
dle, externally, goes a procefs which fupports the 
bones of the nofe. Immediately above the os eth- 
moides in this bone is "a fmall blind hole, through 
which runs a vein into the beginning of the longi^- 
tudinal finus of the dura mater ^ and on the upper 

edge 



OF THE CRANIUM. 13 

edge of each orbit, a fmall perforation, or a notch, 
through which nerves and an artery pafs fecure to 
the forehead ; it has alfo a fmall hole in each orbit, 
near the os planum, through which paffes a branch 
of the fifth pair of nerves. In the fubftance of this 
bone near the nofe are two, three, four, and fome- 
times five finufes, which open into the nofe -, they 
differ very much in different perfons, and are very 
rarely found in children. Thefe finufes, and the 
fpine in this bone, make it very dangerous, if not 
impradicable, to apply a trephine oa the middle 
and lower part of the forehead. 

Os ETHMoiDEs or CRiBRiFoRME IS a fmall 
bone about, two inches in circumference, feated in 
the anterior part of the bafis of the fcull, being al- 
moft furrounded by the laft defcribed bone. It is 
full of holes like a fieve, through which, it is faid, 
the olfadlory nerves pafs, which I could never difco- 
ver. In its middle arifes a large procefs named chri- 
fta galli : And oppofite to this a thin one which in 
part divides the nofe. The greater part of the la- 
minae fpongiofae in the nofe belong to this bone. 

Os SPHENOIDES is of a very irregular figure ; it 
is feated in the middle of the bafis of the fcull, bound- 
ed by the os frontis, ethmoides, vomer, occipitis, 
maxillae fuperioris, ofTa parietalia, palati, malarum, 
temporum, and petrofa, which are parts of the 
former bones. In its infide next the brain is a ca- 
vity named fella turcica, which is bounded by four 
proceffes called clinoides ; under the two foremofl 

of 



14 SUTURES AND BONES 
of which pafs the internal carotid arteries, and from 
their outiides are continued too thin long procelies 
upon that part of the frontal bone, which feparates 
the anterior lobes of the brain from the pofterior j 
oppoiite to the fella turcica is a procefs which makes 
part of the feptum narium. On the outiide of the 
fcuU adjoining to the upper jaw, are two procefles 
of this bone on each fide, named pterygoides, from 
which arife one on each fide near the palate, which 
have no name. Over thefe pafs the tendons of the 
pterygoflaphylini externi mufcles ; and nearer to- 
wards the occiput, between thefe and the ftyloid 
proceflTes of the cfifa petrofa, arife two more fmall 
rugged procelTes -, and under the fella turcica, in 
this bone, is a fin us or two, for the mod part, in 
adults, but in children only fuch a fpongy fubftance 
as is feen in the ends of fome of the bones. Dr. 
Nichols obferves this fnus belongs properly to 
the OS ethmoides. At the infide of the bafis of the 
two anterior clinoid procefiles are two round holes, 
which are the firft foramina of the fcull 5 through 
thefe the optic nerves pafs -, almofl: under thefe, to- 
wards the fides of the fcull, are two irregular flits, 
named foramina lacera, or the fecond foramina of 
the fcull, through which pafs nerves and blood vef- 
fels into the orbits of the eyes ^ and under thefe, 
towards the occiput, are two round holes, which are 
the third foramina, through which pafs nerves to 
the face 5 about half an inch nearer the occiput are 
two more of an oval figure, which are the fourth 

fora- 



OF THE CRANIUM. 15 

foramina, through which pafs the largeft branches 
of the fifth pair of nerves 5 and a ftraw's breadth 
farther two very fmall ones called the fifth fora- 
mina, through which thofe branches of the carotid 
arteries enter that are beftowed upon the dura ma- 
ter. Between this lad defcribed bone and the olla 
petrofa are two large rough holes, in which I have 
{ecn large veins ; and from thefe holes, through 
part of the os fphenoides, under the pterygoid pro- 
cefles, are fmall holes, through which pafs arteries 
to the back part of the nofe. 

OssA TEMPORUMare fituated below the parie- 
tal bones, at the middle and lower parts of the fides 
of the fcuU ; they have each at their back parts one 
large fpongy procefs called mammillaris, or maftoi- 
deus, and from the lower and middle parts of each 
a procefs which joins the offa malarum, named ju- 
galis or zygomaticus. 

O s s A p E T R o s A He between the former bones 
and the occipital bones, or are truly portions of the 
former bones, being never found feparate in adult 
bodies. They have each on. their oucfides one long 
flender procefs called ftyliformis, and near the fide 
of this procefs a foramen, which runs obliquely 
forwards into the fcull, through which the carotid 
arteries pafs to the brain -, thefe are the fixth fora- 
mina, and one foram^en in the infide of the fcull 
leading to the organs of hearing, which are the fe- 
venth foramina. The ridge on the upper parts of 
each of thefe bones helps to keep the brain fleddy, 
3 and 



i6 SUTURES AND BONES 

and are ftrong fupports to the thin and flat parts of 
the fcLil!, which elfe would be exceeding wxak. 
What remains of this bone belongs properly to a 
difcourfe on the organs of hearing, 

Betv/E£N the lail defcribed bones and the fol- 
lowing bone, are two large holes, which are the 
eighth foramina. Through thefe holes pafs the 
eighth pair of nerves and lateral finufes 5 fometimes 
they are two on each fide, one for the nerve and 
one for the finus. To thefe we may add another 
very fmall one on each fide, through which pafs 
the portiones durse of the auditory nerves ; and 
fometimes there is another for an artery. 

Os occiPiTis makes all the back part of the 
fcull : It is bounded by the fphenoidal, temporal, 
petrofal, and parietal bones ; it has two fmail apo- 
phyfes, by which it is articulated to the fpine 5 near 
thofeapophyfes are two fmall foramina, which are 
the ninth of the fcull 1 through thefe pafs the ninth 
pair of nerves ; and between thefe is the great or 
tenth foramen, through which the medulla oblon- 
gata defcends into the fpine, the cervical arteries en- 
ter, and the cervical veins pafs out. In the infide 
of this bone is a crucial fpine imprefled by the lon- 
gitudinal and lateral finufes y and on the outfide 
oppofite to the middle of this fpine, in fome bo- 
dies, is an apophyfis, and from that down to the 
great foramen a fmall thin fpine. The fpines in 
this bone are of the fame ufe with thofe in the os 
frontis, &c. viz. to ftrengthen it. The thinner 

parts 



OF THE CRANIUM. 17 

parts of this bone are alfo defended by the mufcles 
that cover them ; which provifion is very neceflary, 
becaufe we can lead defend this part, and blows 
here are of worfe confequence than on any other 
part of the fcall, becaufe wounds in the cerebellum, 
which is underneath, are mortal. There are in 
molt fculls a foramen behind each apophyfis of the 
occipital bone ; through which pafs finufes from 
the lateral finufes to the external cervical veins : 
By means of thefe communications, as in all other 
communications of the finufes, the blood pafles 
from thofe that happen to be furcharged by any po- 
fture of the head, into thofe that from the fame 
pofture would have been almoft empty. Such 
fculls as want thefe foramina have two finufes for 
the fame purpofe. 



CHAPTER II. 

Of the bones of the face^ &c. 

OSS A NASI make the upper part of the nofej 
they form that kind of arch which is fittefl 
to fuflain fuch injuries as the nofe is moft expof- 
cd to. 

OssA MALARUM. Thefe bones compofe the 
anterior, lower and outer parts of the orbits of the 
eyes 3 they have each a fliort procefs, which pro- 
ceffes join the proceifus jugales of the temporal 

B bones. 



i8 OF THE BONES 

bones, and form arches which have been called olia 

jugalia. 

O ssA UNGUES are feated immediately below the 
OS frontis towards the nofe in the orbits of the eyes y 
whofe anterior and inner parts they help to com- 
pofe ; and between each of them and the upper 
jaw is a foralmen as large as a goofe quill, into which 
the punda lacrymalia lead, to carry off any fuper- 
fiuous moiilure from the eyes into the nofe. 

Oss A PLAN A are feated immediately beyond the 
foregoing bones, in the orbits of the eyes, and are 
near thrice as big. They are rather fmooth furfaces 
of the OS fpongiofum^ than diftindt bones, and are 
very often imperfect. 

Maxilla SUPERIOR Is always defcribed finglej, 
though it is manifeftly divided by a future which 
is fcarce ever obliterated ^ it has two proceifes^ 
which join the os frontis, and make part of the 
nofe, and another, which joins to the cartilage of 
thefeptum nafj. Its upper and outward parts make 
the low^er parts of the orbits of the eyes 3 its lower 
fide, all that part of the face under the cheeks, eyes^ 
and nofe to the mouth, and two thirds of the roof of 
rile mouth. A little below the orbits of the eyes, 
in this bone, are two holes, and behind the dentea 
incifores one more, which divides into two, as it 
opens into the nofe, on each fide the feptum nafi,. 
Between the pofterior grinding-teeth and the orbits 
of the eyes are two great finufes, called antra ma- 
xillas fuperioris^ v/hich open into the upper part of 

the 



OF THE FACE. 19 

the nofe. And in the lower edge of this jaw are 
the alveoli, or fockets for the teeth. Part of the 
fides of thefe cavities, that lie next the ^ nofe, are 
Only membranes which make the cavities like drums, 
perhaps to give a grave found to the voice when we 
let part of it through the nofe ; but brutes not 
needing fuch variety of founds, have thefe cavities 
open to the nofe, and filled with lamelte, which 
are covered with membranes, in which the ol- 
fadlory nerves terminate, for a more exquifite fenfe 
of fmelling than is necelTary for men. Impofthu- 
mations fometimes happen in thefe cavities : The 
iigns of this difeafe are great pain about the part, 
matter in the nofe on the fide difeafed, Itijiking 
breath, ^nd rotten teeth. Mr. Cow per firfl de- 
fcribed this cafe, and the cure ; which is performed 
by drawing out the laft tooth but one, or two, or 
more if rotten ; and through their fockets making 
a perforation into the antrum ; or if drawing a tooth 
makes a perforation^- which fometimes happens, and 
perhaps gave the firfl hint of this cure, then, that 
opening muft be enlarged, if it is not fufficient to 
difcharge the matter. 

OssA PALATi are tv.^o fmall bones that make 
the back part of the roof of the m.outh, and a fmall 
part of the bottom of each orbit. Between the ofTa 
palati and os maxillare near the pterygoid proceffes 
of the fphenoidal bone, are two fmall foramina, 
thro* which arteries and nerves pafs to the palate. 

Bz Os 



20 OFTHE BONES 

Os VOMER is feated between the bones of the 
palate, and the fphenoidal bone. It is alfo joined to 
the procefs of the ethmoides, and part of the lower 
jaw. Its fore part is fpongy, and is continued to 
the middle cartilage of the nofe. This bone and 
cartilage are the feptum nafi. 

Os SPONGIOSUM is ufiially treated as a diftind 
bone, though it is only the fpongy lamina in the 
nofe, of the os ethmoides and ofTa plana, but chiefly 
of the OS ethmoides, to which it always adheres. 
In conlidering thefe lamellae as a diftind bone, we 
follow the ancients, who did not diflinguifh the 
bones of the fcuU only, as they are divided by futures, 
but according to the differences of their texture, 
figure, fituation, or ufe. Thus they called thefe 
parts OS fpongiofum ; a procefs of the temporal 
bone, joined to the os mate, os jugale, &c. 

Maxilla inferior is articulated with loofe 
cartilages to the temporal bones, by two procefles, 
named condyloides. Near thefe arife two more, 
called coronales, and at the infide of the chin a 
finall rough proceffus innominatus. In the infide 
of this bone^ under each proceffus coron.alis, is a 
Iaro[e foramen which runs under the teeth, and 
paffes out near the chin. In this foramen, the vef- 
fels pafs that belong to the teeth 3 and in the upper 
edge of this jaw are the fockets for the teeth, which 
feldom exceed fixteen in each jaw 5 the four firft 
in each are called incifores, the two next canini, 
the reft molares 5 the four laft of thefe are named 

dentes 



OF THE FACE. 21 

denies faplentise, becaufe they do not appear 'till 
men arrive at years of difcretion. The incifbres and 
canini have only one lingle root, but the molares 
more; the eight firft, two ; and the reft, fome three, 
fome four, efpecially in the upper jaw ; where alfo 
they are fpread wider, becaufe that jaw being more 
fpongy than the other, the teeth need more fpace 
to fix them. Each of thefe roots has a foramen, 
through which pafs an artery, vein, and nerve, 
which are expanded in a fine membrane that lines 
the cavity in each tooth. Thefe veflels and mem- 
brane are the feat of the tooth-ach. The teeth of 
children caft oft while they are growing ; but the 
fucceeding teeth arife in new fockets, deeper and 
larger than the former ; for the jaws increaiing fafl- 
er than the teeth, mufl otherwife have left chafms 
between them, fuch as are in the mouths of brutes; 
but where teeth are drawn in adult bodies, the 
fockets clofe, and new ones very rarely fucceed. 



CHAPTER III. 

Of the bones of the trunk. 

TH E bones of the trunk are thofe which com- 
pofe the fpine or chain of bones from the 
head down to the rump, the ribs and fternum, to 
which may juftly be added the ofTa innominata. 
The fpine is compofed of twenty four vertebrae 

B 3 (each 



tt OF T FIE BONES 

(each of which in a young child is three bones) 
befides thofe of the os facrum and coccygis 5 fcwcn 
belong to the neck, the firft of which is called at- 
las, becaufe it immediately fupports the head : its 
,L\Dper fide has two cavities, into which the apo- 
phyfes of the os occipitis are received ; but thefe two 
cavities together, unlike all other joints, are late- 
rally portions of concentric circles, by which means 
they are but as one joint, and fo fuffer the head to 
move eafily lide- ways, which otherv/ife it could no 
rnore do than the knee, v/hich alfo has two heads 
and tv/o cavities. The under fide of this bone has 
a very flat articulation vvith the next, which fits it 
for a rotatory motion. The fecond vertebra is called 
dentata, or axis, from a procefs which paffes thro' the 
former bone, and is the axis upon which it turofi ; 
neverthelefs all the vertebra of the neck contri- 
bute fom.ething to the rotatory motion of the head, 
Theprocefiusdentatus is firongly tied to the. os oc- 
cipitis, and to the atlas by ligam.ents, to prevent its 
hurting the fpinal marrow. Twelve of which be- 
long to the hack, five to the loins. The os facrum 
is fometimes five^ fometimes fix bones, and the os 
coccygis four. If this chain had been compofed of 
fewer bones, they miifl: have either not been capa- 
ble of bending fo much as they do, or have bent 
more in each joint, which would have prelled the 
fpinal marrow, the ill confequences of which are 
fafBciently feen in perfons grown crooked, or who 
l^ave had diftortions from ^:?cterqal accidents. 

1 -^ Tm 



OF THE TRUNK. 23 

The iippermoft vertebra of the neck being 
fixed behind the center of gravity of the head, the 
neck is therefore fo far bent forward, as that the 
lafl: of thefe vertebra (which has a firm bearing up- 
on thofe of the thorax) may be exactly under the 
center of gravity. Thofe of the thorax are bent 
backwards, behind the center of motion, to make 
room for the parts contained in the thorax 3 and 
that they might not be made too weak by this flru- ' 
clure, they are formed for lefs motion than other 
vertebrse ; and thofe in particular, who are bent 
fartheft from the center of gravity have the leaft 
motion. The middle vertebrae of the loins are 
again bent forwards under the center of gravity, or 
near it j and from thence they go backwards to the 
OS facrum, where being fixed to the oflTa innomi- 
nata behind the center of gravity, the articulation 
is therefore firm and without motion, and from 
thence the ofiTa innominata are fo formed, as that 
their fockets into which the thigh bones are fixed, 
where there is a free motion, are exactly under the 
center of gravity. In brutes the fpine is difierently 
formed, according to the anions for which they 
are defigned. 

I N all thefe vertebra, except the firft, is a mid- 
dle anterior fpongy body, by which they are firm- 
ly articulated with a very firong intervening liga- 
ment ) and from the mJddle of the hind part of 
each, except the firfl, ftands a procefs nam.ed fpi- 
nalis, and from every one a procefs on each fide, 

B 4 < called 



24 OF THE BONES 

called tranfverfalis, and two fuperior, and two in- 
ferior lliort ones ; by which the back parts of the 
vertebrae are articulated, named obli(juij fuperiores, 
and inferiores. 

The fore part of the feven vertebras of the 
neck, and two upper of the back, are flat for- 
wards, to make room for the afpera arteria and gu- 
la : The third and fourth of the back acute, to give 
v^ay to the veffels of the lungs and heart, and bent 
to the right fide for the better fituation of the 
heart, w^hich makes that fide of the breaft more 
convex than the other, and therefore flronger ; 
which feems advantageous to the right arm, its 
motions depending upon the fupport it receives 
from the bread. Hence, I think, it feems, that 
the almoft univerfal preference of that arm is not 
an arbitrary thing, but founded upon obfervation, 
that it is capable of more perfedl adions than the 
other. 

THEfpinal proceffesofthefecond, thii-d, fourth, 
and fifth vertebra of the neck are forked, the two 
laft long and horizontal, the three or four upper 
ones of the back hke them, only a little declining, 
the middle ones of the back run obliquely down- 
wards, and the procefl"es of the remaining vertebra 
become fucceflively thicker, flronger, and lefs de- 
clining ; thofe of the loins being horizontal, like 
the laft of the neck. The mufcles that are inferted 
into the fpinal procefles of the vertebra of the neck 
^nd loins will aQ with more ftrength than thofe of 



OF THE TRUNK. 25 

the back, becaufe their proceffes being perpendicii- 
iar to the fpine, they are longer leavers: befides, 
thofe of the back almoft touch one another, to pre- 
vent much motion, becaufe it v^ould interrupt re- 
fpiration; but more motion being neceffary in the 
neck and loins, their proceffes are made fit for it. 

The tranfverfe proceffes of the vertebra of the 
neck are perforated, for the admiffion of the cer- 
vical blood veffels, and bowed downwards, and 
hollowed, for the paffage of the cervical nerves. 
The eight or nine upper ones, of the back receive 
the upper ribs 5 and the refr, with thofe of the 
loins, ferve only for origins and infertions of muf- 
cles. 

Os SACRUM has two upper oblique procefles, 
fome fmall ipinal procefles, and^ two foramina in 
each interftice of the bones it fs compofed of, both 
before and behind. Offa coccygis have none of 
thefe parts. 

Through every bone of the fpine, the oila 
coccygis excepted, is a large foramen, v^^hich toge- 
ther make a channel through the fpine, in which 
is contained the medulla fpinalis 3 and in each 
fpace between the vertebras are two large holes for 
the nerves to pafs out. 

'Tis worth confidering the provlfion which is 
made to prevent luxations in this chain of bones, 
fuch luxations being worfe than any other, becaufe 
of the fpinal marrow which is contained within thefe 
bones. The bodies of the vertebrae are all in the 

fame 



26 OFTHEBONES 

fame manner conneded by flrong intervening liga- 
ments or cartilages. In the neck the obh'que pro- 
celles of the received bone are wrapped over thofe 
of the receiving bone, which forbids their luxating 
forwards. The tranfverfe procelTes with a fmall 
apophyiis of the body of the fame bone, in like 
manner, fecure them from flipping backwards -, and 
an apophyfis on each fide of the body of the receiv- 
ing bone, hinders them from flipping to either 
iide. The vertebrae of the back are hindered from 
diflocating forwards by the fime proviiion with 
thofe of the neck ; and from luxating backwards, 
by the ribs which are faftened to the tranfverfe pro- 
cefles of the inferior vertebrae, and againfl: the back 
part of the body of the next fuperior 5 they alfo 
hinder them from diflocating to either fide 5 but 
the lafc ribs are not fixed to the tranfverfe procefTes 
of the vertebrse of the back, and therefore it is 
that luxations are moil: frequently i^tn in this part ; 
but the vertebrs of the loins are received into deep 
cavities, and are tyed with much ftronger ligaments 
for their fecurity. Each joint of the vertebra, ex- 
cept the two uppermoft, has two centers of mo- 
tion, one upon the bodies of the vertebrae, when 
the trunk is bowed forward ; and the other at the 
articulations of the oblique proceffes, when the bo- 
dy is bowed backwards ; from which flrudure the 
extenfors will have about twice the leaver to a6l 
with, and confequently twice the power to raife 
the trunk into an eredt pofture^ that they have to 

carry 



OF THE TRUNK. 27 

carry it beyond that pofture ; for then the oblique 
procefles begin to be the centre of motion, and give 
a like advantage to the benders. Without this con- 
trivapxe it would be more difficult to keep the bo- 
dy ereft, or to recover an ere6t pollure with con-^ 
iiderable ftrength after a bend of the body. 

The ribs are twelve in number on each fide; 
the feven uppermoft are called true ribs, becaufe 
their cartilages reach the fiernum; and the five 
loweft are called baftard ribs. They are articulated 
to the bodies of the tv/elve vertebrs of the back, 
and all, except the two or three la ft, are articu- 
lated to their tranfverfe procefles, and the under 
fide of the middle ribs are hollowed for the paflage 
of the intercoftal veflels. They defend the parts 
contained in the breall, and when they are drawn 
, upwards, the cavity of the breaft is enlarged for 
infpiration, and fo the contrary. In two children 
which I have dilTccflcd, I found the ribs broke in- 
wards, and on the outfide a very plain print of a 
thumb and fingers, occafioned by their nurfes tak- 
ing hold of their breafts, and hoifting them up on 
one hand, which being often repeated, had broke 
the ribs inwards like a green (lick, without feparat- 
ing the broken ends of them. I have alfo very fre^ 
quently feen the ihape of childrens breafts quito 
fpoiled by fuch tricks, which have occafioned weak- 
nefs of body, crookcdnefs, and other difeafes. 

Sternum, or breaft- bone, is generally made 
up of three fpongy bones, fometimes more ; to this 

the 



^8 OF THE BONES 

the true ribs are articulated by their cartilages, which 
fometimes in robuft men have moveable joints, fuch 
as are feen in oxen and other quadrupeds. At the 
end of the fternum is the cartilago enfiformis, fo 
called from its (liape, but it very often is double ; 
there is alfo frequently found variety in the form of 
the cartilages, which join the ribs and fternum^ 
fometimes one cartilage ferving two ribs, and fome- 
times a cartilage not joined to any rib j frequently 
in old perfons we find parts of them offified, and 
I have twice found them totally offified in men be- 
tween forty and fifty years of age, both of which 
died with a great difficulty of breathing 5 and be- 
lides, one had a jaundice, and the other a dropfy, 
but the lungs in both were very found. 

There are feldom found fewer than four and 
twenty vertebrae in the fpine, befides the os facrum, 
but often more ; fometimes thirteen of the back, 
with as many ribs of a fide ; and fometimes fix in 
the loyns : and in feme bodies two ribs from the 
firfl: vertebra of the loyns, but then it has wanted 
tranfverfe procefles. 

Os INNOMINATUM is in young perfons com- 
pofed of three bones ; the upper is named ilium, 
the lower and poflerior os ifchii, and the anterior 
OS pubis ; the upper edge of the ilium is called its 
fpine, the anterior part of the fpine its apex, and a 
little lower is the proceflTus innom.inatus. Ilium 
has two procefles, the one named the obtufe pro- 
cefs, and the other the acute 5 jn the centre of 
" thefe 



OF THE TRUNK. 29 

thefe bones is the acetabulum or focket for the 
thigh bone ; in the bottom of which focket is an- 
other cavity, in which lies the lubricating gland of 
this joint. When impoflumations happen in this 
joint they ufually caufe a great fwelling and lame- 
nefs in the hip, which, in time, makes a colledlion 
of matter in the external part of the hip ; however, 
this is not the only way it proceeds, for I have 
twice feen the matter in the joint make way thro' 
the bottom of the acetabulum into the pelvis of the 
abdomen -, in thefe cafes, when the patient went 
to ftool, the matter by draining was prefs'd out 
thro' the external wound. 



CHAPTER IV. 

Bones of the upper limb 9 

CL AV I C U J. A is conneded at one end to the 
flernum with a loofe cartilage, and at the 
other to the proceffus acromion of the fcapula ; its 
chief ufe is to keep the fcapula a fufficient diftance 
from the breaft, by which means the fhoulders are 
hindered from coming near together, as they do in 
thofe quadrupeds which ufe their fore limbs only to 
walk on, and not as men do their hands. 

Scapula is fixed to the flernum by the clavi- 
cula, but its chief connedion is to the ribs and 
fpine, by thofe mufcles which are made alfo for its 

various 



30 B ONE S OF THE 

various motions ; and in fuch quadrupeds as haVe 
no clavicles it is fixed only by mufcles, whofe 
adions give to this bone a great deal of that motion 
which feems to be in the joint of the fhoulder. 
The under fide of this bone is a little concave, 
partly to fit it to the outer furface of the ribs on 
which it moves, and partly to give room for the 
fub-fcapularis raufcle. On the outfide arifes a large 
Ipine ; the fore part of which is called the proceflTus 
acromion, to which the clavicula is fixed. In men 
and fuch quadrupeds as have clavicles, and ufe their 
fore limbs like arms, this procefs and fpine are 
much larger and more prominent, not only for 
the better fixing- the clavicle, but alfo to remove 
the mufcles farther from the center of motion, 
whereby they are able to move a greater weight. 
Near this procefs is another called coracoides, from 
whofe extremity, v/ith like advantage, arife two 
mufcles of the arm ; this procefs with the former, 
and a flat ligament between them both, hinder the 
OS humeri from being diflocated upv/ards. The fide 
oppofite to the focket is called the bafis of the fca- 
pula, and the lower edge coila inferior from its fi- 
gure, which is thick, and like a rib to the fcapula ; 
but its upper edge being very thin, is improperly 
fo called in the human fceleton, though not fo in 
many quadrupeds. At the fore part of this edge, 
clofe to the coracoid procefs, is a femicircular nitch 
for the paffage of blood veiTels, which nitch is join- 
ed 



UPPER LIMB. 31 

ed at top with a ligament, and fometimes with 
bone. . - 

Os HUMERI : its upper end or head, where it 
is joined to the icapula, is fomewhat fiat and much 
larger than the focket whieh receives it. At the 
upper part are two proceffes for the infertions of 
mufcles of the arms ; between thefe proceiles is a 
long channel, in which lies a tendon of the biceps 
cubiti. At the lower end are tw^o confiderable pro- 
cefies, both formed to give origins to mufcles of 
the v^rift and fingers ; and the flexors of thefe joints 
being much more confiderable than the extenfors, 
the inner procefs from which the flexors arife is^ 
therefore much larger than the outer, from which 
the extenfors take their origin : between thefe pro- 
ceffes is the joint. That part to which the upper 
end of the radius is fixed, is fitted not only for the 
motion of the elbow, but alfo for the rotatory mo- 
tion of the radius 3 the reft of this joint is made of 
portions of unequal, but concentric, circles, like the 
fhanks of quadrupeds ; which inequality prevents 
the ulna from diflocating fideways, which fo fmall 
a joint with fo much motion would be very fubje(fi 
to. Of a like ufe is the little finus on the fore part 
of the humerus, and the large one behind; the 
fitft of which receives a procefs of the ulna v/hen 
the arm is bent, and the other, the oiecranonj^ 
when the arm is extended. 

Ulna : at the upper end it has one large pro-, 
cefs called olecranon, and a fmall procefs on the 

fore 



32 BONE S OF THE 

fore part ; and on one fide between thefe is alfo 
a fmall cavity, which receives the upper end of 
the radius for its rotatory motion ; and down the 
fide of this bone, next the radius, is a fliarp edge, 
from which the ligament arifes, which conneds 
thefe bones together. At the lower end is a pro- 
cefs, called fi:yliformis, and a round head, which 
is received into the radius for the rotatory motion 
of the cubit. 

Radius : its upper end is received into the 
ulna, and joined to the hum.erus^ in a manner 
chiefly fitted for its rotatory motion, for the ftrength 
of the elbow joint receives but little advantage from 
the union of thefe two bones. A little below this 
head is a large tubercle, into which the biceps muf- 
cle is inferted, which by the advantage of this in- 
fertion turns the cubit fupine, as well as bends it. 
At the lower end, which is thicker, is a focket to 
receive the carpus, and at the fide next the ulna a 
fmall one to receive that bone, and a thin edge, 
into which the tranfverfe ligament, which arifes 
from the ulna, is inferted. This ligament ties thefe 
bones conveniently and firmly together; for the 
ulna being chiefly articulated to the os humeri, and 
the radius to the carpus, a weight at the hand, 
without this ligament, would be liable to pull thefe 
bones afunder. 

Of the bones of the hand : Carpus is compofed 
of eight bones of very irregular forms, undoubted- 
ly the properefc that can be 5 yet why in thefe 

forms 



UPPER LIMB. 33 

forms, rather than any other, no one has been a- 
ble to {hew. They have all obfcure motions one 
with another, and with thofe of the metacarpus ; 
but the motion of thofe of the firfi: rank, or order, 
with thofe of the fecond is more confiderable, and 
are moved by the fame mufcles which move the 
carpus on the radius. The metacarpus confifts of 
four bones which fuftain the fingers ; that of the 
fore-finger having the leaft motion, and that of 
the little one the moft : the other ends of thefe 
bones have round heads for the articulations of the 
fingers -, but the other joints of the fingers double 
heads and fockets. The thumb is (horter and 
ftronger than any of the fingers, becaufe in its 
aftions it is to refift them all. The firft joint is very 
Angular, each bone receiving and being equally 
received. The bones of the fingers on the infide 
are flat and a little hollow, which is neceffary to 
make room for the flexors of the fingers, and to 
render their fhape proper for grafping ; but this 
leflTening their diameters, and confequently weak- 
ening them in the diredlion in which they are 
moft liable to be broke, fuch inconvenience is pro- 
vided againft by a larger fubftance. 



CHAPTER 



34 B O N E S O F T H E 

CHAPTER V. 
Bones of the lower limb. 

OS FE MORIS at its upper end has a round head 
which is received into the focket of the os 
ianominatum. In moft quadrupeds this head is 
cbiong, and makes a firmer articulation 5 but that 
fliape will not allow of fo much motion as a round- 
er head. The two proceiTes near the head are 
called the greater and leffer trochanters, which are 
evidently formed for the infertlon of m^ufcles, as 
the neck which lies between thefe and the head, is 
form.ed to make room for that neceffary quantity of 
mufcles which are feated on the infide of the thigh, 
and alfo by projediiig outwards to make long le- 
vers for the mofcles, which are inferted into its up- 
per and external parts. Between the great trochan- 
ter and the neck is a large finus, into w4iich muf- 
cles are inferted: between the two trochanters is a 
Temarkable rotighnefs for the fame ufe, from, which 
begins the linea afpera. The middle of this bone, for 
the eonveniency of the mufcles J is bent forwards, 
wHiich' woliid^feake it fobjed: to break backwards, 
if there was not a ftrong ridge on the back fide, 
which (trengthens it ilifficiently, and ferves alfo 
for advantageous infertions for feveral mufcles 3 this 
ridge is called the linea afpera. At the lov/er end 
of this bone are two large heads, called the outer 

and 



tOWER LIMB. 35 

and inner apophyfes : thefe are fo contrived, partly 
from being projected backwards, and partly from 
their fliapes, as to remove the center of motion ve- 
ry far behind the axis of the bone, which gives 
great power to the mufcles that extend this joint to 
raife the whole weight of the body, though it lef- 
fens the power of the benders which move the leg 
only ; between thefe proceiTes the large veffch de- 
fcend fecurely to the leg. 

Patella isfeated on the forepart of the knee; 
its fird appearance is in the centre of the tendon, 
through which it foon extends, until the tendinous 
fibres are loft, and appear to be converted into 
bone 5 however, when this bone is broke, the ori- 
ginal tendinous fibres feem to prevail, feeing the 
broken parts, unlike all .other bones when fradiired, 
unite with a tendon-like fubftance, which is rarely 
converted into bone, and efpecially in thofe cafes 
where the joint recovers with moft motion : its ufe 
is to fecure the extenfors of the tibia, left palllncr 
over the joint, they m.ight be too m.uch expofed to 
external injuries 5 it alfo increafes the advantage 
(mentioned in the laft paragraph) of removing the 
common axis of the extenfors of the tibia farther 
from the centre of motion, and is a moft conve- 
nient medium for thofe m.ufcles to unite in, to perr 
form one common adion. 

Tibia, the ihin bone, is large at its upper end, 
where are two fliallow fockets which receive the 
thigh bone 5 between thefe is a roug^h orocels, to 

C 2 which 



36 BONES OF THE 

which the crofs ligaments of this joint are connedl- 
ed. Near the upper end is a procefs, into which 
the ligament or tendon of the patella is inferred, and 
at the lower end is the procefs, which makes the 
inner ancle, and fecares this bone from diflocating 
outwards. Towards the upper end this bone is tri- 
angular, and even concave on the fide next the 
mufcles to make room for them ; but lower, as 
the mufcles grow lefs and tendinous, the bone 
grows rounder ; that being upon the whole a ftronger 
form ; yet it is not made fo ftrong as the thigh 
bone, though it bears a greater weight, which it is 
able to do by being ftraighter, fliorter, and bear- 
ing the weight of the body in a more perpendicular 
diieftion. 

Fibula is feated on the outfide of the tibia; 
its upper end is joined to that bone below the joint 
of the knee, and its lower end is received into a 
iliallow finus of the fame bone, and below that 
makes th^ external ancle ; which procefs, with the 
procefs of the tibia, ftrengthens the ancle joints 
which neverthelefs, being fo fmall, would have been 
not flrong enough, if it had been made for more 
iriOtion. It is doubtful to me, whether or not this 
i tone contributes to the fupport of the body ; but 
its great ufe is for the origins of mufcles, and even 
its iliape is fuited to theirs. 

Of the bones of the foot : Tarfus is compofed 
pf fcYtn bones, the firft of which, called aftraga- 
Fus, fupports the tibia, and is fupported by the os 

calcis. 



LOWER LIMB. 37 

calcis, which being projeded backwards, makes a 
long lever for the mufcles to adt with, that extend 
the ancle and raife the body upon the toes. Thefe 
two bones have a confiderable motion between them- 
felves, and the aftragalus alfo with the os navicu- 
lare, and all the reft an obfcure motion one with 
another, and with the bones of the metatarfus, the 
greateft part of thefe motions being towards the 
great toe, where is the greateft ftrefs of adion : 
thefe bones thus giving way are lefs liable to be 
broke, and, as a fpring under the leg, make the mo- 
tions of the body in walking more eafy and grace- 
ful, and the bones which are fupported by them 
lefs fubjedl to be fradured in violent adlions. To 
thefe join five others called the metatarfal hones ; 
that which fupports the great toe is much the lar- 
geft, there being the greateft ftrefs in walking ; un- 
der the end of this lie the two fefamoid bones, 
which are of the fame ufe as the patella -, the great 
toe has two bones, the Icfler three each, the two 
laft of the leaft toes frequently grow together. 

Children are fometimes horn v*^ith their feet 
turned inwards, fo that the bottom of the foot is 
upwards : in this cafe the bones of the tarfus, like 
the vertebras of the back in crooked perfons, are 
faftiioned to the deformity. The firft knowledge 
I had of a cure of this difeafe was from Mr. Pres- 
GRovE, a profeifed bone-fetter, then living in 
Weftminfter. I recommended the patient to him, 
not knowing how to cure him myfelf. His way was 

C3 by 



3§ . BONES OF THE 

by holding the foot as near the iiataral pofture a$ 
he could, and then rolling it up with ftraps of 
flicking plafter, which he repeated from time to 
dme, as he faw occaiion, until the limb was re- 
flored to a natural pofition, but not without fome 
imperfedion, the bandage wafting the leg, and 
making the top of the foot fwell and grow larger. 
After this^ having another cafe of this kind under 
my carCj I thought of a much better bandage, 
v/hich I had learnt from Mr. Cow^per, a bone- fet- 
ter at Leicefter, who fee and cured a fradure of my 
pv/n cubit, when I was a boy at fchool. His way 
waSj after putting the limb in a proper poPcure, to 
wrap it up in rags dipp'd in the whites of eggs, and 
a little wheat flower mixed ; this drying, grew ffifr, 
and kept the limb in a good poflure. And I think 
there is no way better than this in fradures, for it 
preferves the pofition of the limb without flrid ban° 
dage, which is the common caufe of mifchief in 
fradures. When I ufed this method to the crooked 
foot, I WTapt op the limb almofl: from the knee to 
the toes, and caufed the limb to be held in the beft 
poflure 'till the bandage grew ftiff, and repeated 
the bandage once a fortnight. 

The bones' are fubjed to difeafes from all the 
fame caufes that the other parts are, but either from 
their hardnefs, infenfibility, or other caufes, they 
neither are fo frequently difeafed, nor do their dif- 
eafes appear fo various, and it is generally of more 
ccnfequence what texture the difeafed bone, or part 

of 



LOWER LIMB. 39 

of the bone is of, than from what caufe that dif- 
eafe proceeded ; for when difcafes happen upon the 
farfacesof the hard bones, they ufiially admit a cure 
by exfohation 5 but when matter is made in the 
fpongy ends of the cylindrical bones, or in the bo- 
dies of other fpongy bones, the matter, whatever 
was the firfl caufe, infmuates itfeli through thofe 
fpongy cells, fwelling tlie bone, and making gene- 
rally an incurable caries ; but if the maatter is corro- 
iive, it often ulcerates thefe parts, and ufually 
makes fo large a difcharge as to deftroy the patient 
where the part difeafed cannot be extirpated, which 
is often the cafe when matter is made in the bones 
in fcrophulous habits. 

The venereal difeafe rarely attacks any but the 
hardeft parts of the bones, very foon railing large 
tum.ors and caries or mortification ; but theie carious 
parts of bones from this or other caufes are but par- 
tially mortified J for, were they perfedly fo, the found 
and unfound parts would feparate though the inte- 
guments were not taken oft ; whence it happens, 
that, where there is a good habit of body, carious 
bones are often endured many years without much 
inconvenience ; and we find from experience, that 
fuch feparations are not to be made 'till the difeafed 
part is laid bare and perfedlly mortified by being 
expofed to the air, &c. and then the found part un- 
derneath feparating from the unfound, there firll: 
granulates a fungous flefti-like appearance, w^hicli 
ought aever to be treated with corrofive medicine?, 

C 4 if 



40 BONESOFTHE 

it conftantly flirinking and hardening of itfelf, be- 
ing the fame fubftance which (hoots from the ends 
of broken bones, where alfo it foon fhrinks and 
converts into a callus to reunite them. 

There is a caries diftind: from thefe, which I 
have only icQn in two patients who died after a long 
rheumatic diforder, in which the outer furface of 
all the hardeft bones, as the middle of the cylindri- 
cal bones, and the top of the fcull, in one which 
I boiled, and in the other as far as I was allowed 
to examine, I found the outer part every where 
crumbly or fcaly, falling into pieces like dufl or 
fand, with very little appearance of tumor any 
where, and no appearance of difeafe in the fpongy 
parts. 

Sometimes matter is formed in the large me- 
dullary cavities of the cylindrical bones, which con- 
ftantly Increafing and wanting vent, partly by cor- 
roding and rendering the bone carious, and partly 
by preffure, tear afunder the ftrongeft bone in an 
human body, of which I have known feveral in- 
ftances. In one cafe, where the matter had fuffi- 
cient difcharge by an external caries formed together 
with the internal one, all the interpal hard part of 
the bone which contains the medulla was feparated 
from the reft, and being drawn out through the 
place v/here the external caries made a vent, the 
patient received a perfect cure. In another cafe of this 
kind, where the internal part which contains the 
medulla wa5 alfo feparated fi'om the j-eft, apd there 

being 



LOWER LIMB. 41 

being holes through which the matter was difvharg- 
ed, bat none fufficient to take out the exfoliated 
bone; the matter continued to flow in great quan- 
tity 'till it deftroyed the patient -, and poffihly if this 
cafe had been rightly known, the internal exfo- 
liated part might have been taken out, and the pa- 
tient cured. In both thefe cafes it feems as if only 
fo much qf the internal part of the bone was be- 
come carious as receives nourifhment from the ar- 
tery which enters the middle of the bone ; and as 
a caries js a mortification of a bone, might not this 
difeafe arife from a hurt in the veffel which nou- 
rifhes that particular part ? 



CHAPTER VII. 

Cartilages^ ligaments^ &c. 

EV E RY part of a bone which is articulated to 
another bone for motion, is covered or lined 
with a cartilage, as far as it moves upon, or is mov- 
ed upon by another bone in any adion 3 for car- 
tilage being fmoother and fofter than bone, it ren- 
ders the motions more eafy than they would have 
been, and prevents the bones wearing each other in 
their adions. 

In each articulation of the lower jaw, there is a 
loofe cartilage, upon which the condyloid procefs 
moves en one fide, while the mw is moved to the 

oihctf 



42 CARTILAGES, 

other 5 and the two proceiTes being thus raifed at 
once, the jaw is thruft forward. Thefe cartilages 
are alfo found in animals that chew the cud, but 
not in beafts of prey, as far as I have examined, 
their articulations being alfo deeper and firmer; and 
in the o'ter particularly, fections of the fockets 
which receive the condyloid prcceffes of the lower 
jaw, are more than half circles; fo that the jaw 
cannot be diflocated diredly without breaking the 
fockets. This firudure renders the motions of the 
jaw more firm, as that with intervening cartilages 
makes it more loofe and voluble. There are alfo 
cartilages of this kind between the clavicles and the 
fternum. 

In the joint of the knee are two loofe, almoft 
annular cartilages, which being thick at their outer 
ed^^es, and thin at their inner ones, they make the 
greateil parts of the two fockets in this joint. The 
ufe of thefe cartilages is to make variable fockets to 
fait the diiferent parts of the lower end of the os 
femoris ; for none but a round head and a round 
cavity can fuit in motion, unlefs the fhape of one 
or the other alters; and it is plainly neceffary, that 
this lower end of the os femoris (hould be fiattiflij 
and prpjeded backward, to give advantage to the 
mufcles that exend the tibia, by fetting the center 
of motion backward : which mechanifm, though 
it equally leiTens the power of thofe mufcles which 
bend this joint, is yet of great fervice, becaufe the 
extending mufcles move this joint under the v/eight 

of 



LIGAMENTS, &c. 43 

©f the whole body, but the flexors only raife the 
legs 5 and as no head or focket moves fo eafily as 
round ones, here feems to be fome proviiion made 
againft the inconvenience of a flattiilj head and ca- 
vity, by having the friftion made upon two fur- 
faces, the OS femoris upon the loofe cartilages, and 
the loofe cartilages upon the tibia. This contrivance 
is pradifed by mechanics, where the fridtioa of the 
joints of any of their machines is great, as between 
the parts of hook-hinges of heavy gates, and be- 
tween the male and female fcrews of large vices, 
where they ufually place a loofe ring. 

There are other cartilages which ferve to give 
ftiape to parts. Of this fort are the ciliary carti- 
lages at the edges of the eye-lids, the cartilages of 
the outer ears, and thofe which compofe the lower 
part of the nofe, which have this particular advan- 
tage in thefe places, that they fupport and fhape 
the parts as well as bones do, and without being 
liable to be broke -, and to thefe might be added 
thofe of the larynx, but they do not belong pro- 
perly to the fceleton. 

Bones that are articulated for motion are 
tied together by very ftrong ligaments, to pre- 
vent their diflocating, which alfo furround the 
joints to contain their lubricating mucus. The 
thicknefs and flrength of thefe ligaments are pro- 
portioned to the adions of the feveral joints, and 
their lengths are no more than fufficient to allow a 
proper quantity of motion 3 but the forms of them 

3 ^^^ 



44 CARTILAGES, 

are different according to the different aftions of the 
feveral joints. 

Th e bones of the limbs that move to all fides 
have ligaments like purfes, v^hich arife from or 
near the edges of the fockets of the receiving bones, 
and are inferted all round the received bones a little 
belov^ their heads. The beginnings of thefe liga-- 
ments, from the edges of the fockets of the fcapula 
and OS innominatum, are very hard, almofl cartila- 
ginous, which fcives in the fcapula to make a lar- 
ger focket, and fuch an one as v^ill alter its figure 
as the bone moves, for the reafon I have mentioned 
in ihe loofe cartilage of the knee : for the head of 
the OS humeri not being an exadl portion of a fphere, 
requires fuch a focket, and the hard part of this li- 
gament of the focket of the os innominatum makes 
the focket deeper than the femidiameter of the 
focket, by which means the articulation is made 
flronger without any hindrance to motion, becaufe 
it will give way to the neck of the cs femoris when 
it prefTes againfl it ; and the thigh bone being more 
difpofed to be diflocated upwards than any other 
way, the upper fide of this burfal ligament is made 
exceeding flrong to prevent fuch an accident. From 
the lower edge of the acetabulum or focket of the 
OS innominatum arifes a ligament about an inch 
long, called teres, or rotundurn, which length is 
neceffary for that quantity of motion which this 
joint has in human bodies -, it aUb hinders the os 
femoris from diflocating upwards, but downv/ards 

it 



LIGAxMENTS, &g. 45 

it will fufFer it to go far oiit of the focket ; but in 
brutes the head of the os femoris being oblong, and 
the cavity fuitable, there can be only a rotatory 
motion, which in effedt will be very little moro- 
than that kind of motion which is called bending 
and extending ; and this never removing the end of 
the head of the bone far in the focket, a ihort li- 
gament is enough for it, and will better keep the 
bone in its place ; and therefore it is that theirs is 
fo ftiort. This ligament in men may alfo ferve to 
prefs the gland in the bottom of the acetabulum 
or focket* 

The ligaments of thofe joints which admit only 
of flexion and extenlion, differ from the former in 
this, that they are much fliorter and ftronger at 
the fides of the joints, and thinner backward and 
forward. Befides thefe ligaments, in the middle and 
back part of the joint of the knee, are two very 
ftrong ligaments which arife from a procefs at the 
end of the tibia. They crofs each other in fuch a 
manner, as is beft to fecure the joint from being 
difplaced any way ; they alfo hinder the extenfors 
of the tibia from pulling that bone too far for- 
wards, and are fo collected to the femilunar car- 
tilages, as to move them as the joint moves ; be- 
fides thefe, in this joint is another fmallone, which 
arifes from the os femoris, and ends in the fatty 
membrane which it fupports. The knee, I think, 
cannot be completely diflocated without breaking 
the crofs ligaments : I have km this cafe but once, 

the 



46 CARTILAGES, 

the bone indeed was eafily refiored to its place, but 
to no purpofe. 

The bones of the carpus and tarfus are tied to- 
gether by ligaments running promifcuoufly upon 
their furfaces from one to another 3 which at the 
under fide of the tarfus are vaftly ftrong, becaufe 
they fupport the whole body ; thefe ligaments to- 
gether contain the mucus for all thofe joints. There 
is alfo to the carpus a ftrong ligament, which runs 
from the fifth bone to the eighth, and the procefs 
of the fourth bone : the proper ufe of this is, to 
bind down the tendons of the mufcles that bend 
the fingers. 

The proceflTus dentatus of the fecond vertebra is 
tied to the fcull by a ligament, and kept clofe to 
the forepart of the firft vertebra by another in that 
vertebra, that it may not bruife the fpinal mar- 
row ; and when either this ligament or procefs is 
broke, it makes that fort of broken neck which is 
attended with fuddeii death. All the bones of the 
vertebra, and every joint that is without motion, 
and not joined by a future, as the ofTa innominata 
with each other, and the os facrum with the ofTa 
innominata, are joined by intervening ligaments, 
or, as they are commonly called, cartilages. The 
offa innominata are alfo tied by very ftrong liga- 
ments which run from the back parts of the fpines 
of the ofla ilia to the os facrum, and other liga- 
ments which go from the os facrum and os coccy- 
gis to the acute and obtufe proceffes of the oflFa if- 

chia: 



L I G A M E N T S, &c. 47 

chia : thefe ligaments ferve alfo for origins of muf- 
cles. Towards the great foramen of the cffa inno- 
minata the acetabulum has a deep notch, from the 
one fide to the other of which runs a ligament 
which completes the focket ; this ligament is fome- 
times offified : a ligament fomewhat like this there 
is between the proceffes of the fcapula. 

From the edge of the ilium to that of the cs 
pubis, runs a ligamicnt which is contiguous to, 
and appears to be a part of the tendons of the muf- 
cles of the abdomen -, its ufe is to cover the iliac 
veflels as they defcend to the thigh. Under this li- 
gament, together wdth the veflels, \ have often 
i^cn. a rupture of matter, and, I think, fometimes 
of the gut, from the abdomen into the anterior 
part of the thigh, immediately below the groin ; 
however, I dare affirm this to be a pofTible Co.k, 

It is generally agreed, that the ligaments are in- 
fenfible ; and the reafon affigned is, that they would 
elfe be injured by ordinary motions. Bat they are 
much better contrived, feeing none of them, not 
even thofe which lie bet'veen the vertebra, are fub- 
jedt to attrition ; but the other, experience (hews, 
are capable of very acute pains, there being not any 
thing our patients more grievoufly cpm^plain of, 
than colledions of matter within thefe parts, or 
(harp medicines applied to them when laid bare. 

Every joint, where the bones are faced with a 
cartilage for a Aiding motion, is furni(hed with 
fmall glands, which feparate a mucilaginous mat- 
ter 



48 d A R 1 1 L A G E S, 

ter for the lubricating of the ends of the bones, that 
they may move eafily upon one another ; and that 
there may be no wafte of this neceffary fluid, it is 
contained in the inverting ligaments ; which for 
this very reafon are no whefe divided, except to 
communicate w^ith the ligaments of the tendons. 

These glands are generally feated in a little fat 
near the infertion of the ligaments, that they may 
Ix comprefled by them when the joints are in mo^ 
tion 5 which is a proper time to have their fluid 
prefled out. The rnofl coniiderable parcel of thefc 
glands with their fat, are fcen In the joint of the 
knee, and the largeft gland of this fort is found in 
the iinus at the bottom of the acetabulum of the 
OS innominatum, and is comprefled by the liga- 
mentum teres. 

The difeafes of the joints either happen from 
ulcers in the lubricating glands, which pouring out 
matter that cannot be difcharged, foul the ends 
of the bones, or elfe from fwellings in the ends of 
die refpeftive bones. Either of thefe in time create 
excefTive pain, which appears to me to be chiefly 
in the ligaments of the joints, notwithftanding what 
has been faid of the infenfibility of thefe parts. 
When a joint is much fwelled, and painful with- 
out external inflammation, it is vulgarly called 
a white fwelling, and more properly than fpina 
ventofa. It is fometimes in the beginning cured 
by evacuations, but when the limb waftes below 
the fwelling, and the fingers or toes of die iimb 



LIGAMENTS, &c. 49 

grow thinner at their joints, and lofe their fliape, 
the cafe then is abfolutely irrecoverable. Some- 
times the ends of the bones erode, then join toge- 
ther and form an anchylofis, which, though a fe- 
vere difeafe of itfelf, yet it is often a remedy of 
one that is much worfe. In Hke manner the bones 
of the hands and feet, when they are ulcerated, 
fometimes unite, and are thus preferved from total 
ruin. But there is one cafe of a white fwelling 
that is amazing, where the pain is fo great that we 
are forced to take off the limb, and yet neither 
find upon diffedlion the ligaments or glands difeaf- 
ed, nor matter in the joint, nor the bones carious, 
or any difeafed appearance, except that the ends 
of the bones are a little larger and fofter. 



D TAB. I. 



( 50 } 
TAB. L 

A, The fceleton of a child twenty months old^ 

in which all the bones differ in {l:iape from 
thofe of an adult. The fcull is much larger 
in proportion, and the bones of the limbs 
without thofe roughneffes and unevennefles 
which afterwards appear; their texture is 
every where more looie and fpongy, and their 
outlines what the painters call tame and in- 
fipid; their extremities are feparate and 
formed cartilaginous, which is accurately 
diftinguiflied in the plates by the manner of 
graving. 

B, The thigh bone of a man fawed through^ in 

the middle of which is f&cn the cavity which 
contains the oily marrow, and at the extre- 
mities the lefier cells which contain the 
bloody marrow. The white line acrofs the 
head of this bone beginning at the fingers of 
the fceleton is the place where the epiphyfis 
and the bone are united. A like line acrofs 
the lov^v^er end of this bone fhews there the 
fame thing. 

C, The OS bregmatis of a fcetus fix months old^ 

which fcews the fibres ofljfying from the 
centre to the circumference. 



TAB. IL 



TABX 



P.^. 




^miM 



TAB .11. 



P.5/. 





(51 ) 
TAB. II. 

1 Os frontis. 

2 Os bregmatis. 

3 Os temporis. 

4 Os occipitis. 

5 Os mate. 

6 Os maxillae fuperioris. 

7 Os nafi. 

8 Os planum. 

9 Proceffiis maftoideus. 

10 Proceffas ftyloides. 

1 1 Proceffus pterygoides. 

12 Dentes. 

2 3 Proceffus coronalis. 

14 Proceffus condyloides. 

15 Dentes. 



D2 TAB. IIL 



( 52 ) 

TAB. III. 

1 Os fronds. 

2 Os bregmatis. 

3 Os occi^itis. 

4 Sella turcica. 

5 A procefs of the os fphenoldes making part 

of the feptum nafi. 

6 A procefs of the os ethmoides making part 

of the feptum nafi, 

7 Vomer, 

8 Crifca galli, before which is {cen in fhadow 

the finus frontalis, 

9 The cornua of the os fphenoides. 
ID Sella turcica. 

1 1 Os frontis. 

1 2 Criila galli and os ethmoides. 

1 3 Sinus frontales. 

14 Sella turcica. 

15 The fifth foramen. 

16 Proceffos jugales. 

17 Os petrofume 

18 Foramen magnom. 

19 The outfide of the os occipitis. 



TAB. IV. 



TAB.nr. 



1^.31. 






1 



T.AB.IV. 



^^3. 




( 53 ) 

T A B. IV, 

1 The fecond vertebra of the neck. 

2 The tranfverfe procefies of the vertebrae of 

the neck. 

3 Clavicula. 

4 The proceffus acromion of the fcapula. 

5 Os humeri. 

6 The ribs. 

7 The tranfverfe proceffes of the vertebras of 

the loins. 

8 The OS facrum and os coccygis. 

9 Os ileum. 

10 Os ifchium. 

1 1 Os pubis. 

12 Os femoris. 



D 3 T A B. V. 



( 54 ) 

TAB. V. 

1 The under fide of the firil vertebra of the 
neck. 

2 A fide view of the fecond vertebra. 

3 The procefllis dentatus of the fecond vertebra. 

4 The under fide of the oblique procefs. 

5 The fpinal procefs. 

6 The under fide of the body of the feventh 
vertebra of the neck. 

7 The tranfverfe procefies. 

8 The oblique procefifes. 

9 The fpinal procefs. 

I o The fpinal procefs of the fecond vertebra of 

the back. 

I I The under and fore fide of the body of the 

vertebra. 

1 2 The tranfverfe procefies. 

13 The upper oblique procelTes of the third 

vertebra of the back, 

14 The tranfverfe procefifes. 

15 The fpinal procefs. 

16 The body of the third vertebra of the loins, 

17 The tranfverfe procelTes. 

1 8 The upper oblique procefTes. 

19 The fpinal procefs. 



TAB. VI. 



TABV. 



P-54- 





lAB.VI. 



P^55- 




( 55 ) 

TAB. VI. 

1 The head of the os humeri, 

2 The outer extuberance. 

3 The inner extuberance, 

4 That part which joins with the ulna. 

5 The olecranon of the ulna, 

6 The lower end of the ulna which joins to 

the radius. 

7 ProcefTus ftyloides. 

8 The upper end of the radius. 

9 The tubercle, 

JO The part of the radius which joins with the 

carpus. 
II, 12, 13, 14, 15, 16, 17, 18, The eight 

bones of the carpus. 



I 



D4 TAB. VII. 



(56) 

TAB. Vli, 

I Radias, 
•2 Ulna. 

3 Carpus. 

4 The three bones of the thumb. 

5 The four bones of the metacarpus. 

6 The three bones of the fingers. 



T A B. VIIL 



Tj^B.Vn. 



P.3^. 




TABVIH. 



E^: 



/o. 




mm 





( 57 ) 
TAB. VIII. 

1 The head of the 03 femoris. 

2 The great trochanter, 

3 The leffer trochanter. 

4 The lower end which articulates with the 

tibia. 

5 The upper end of the tibia. 

6 The lower end of the tibia. 

7 The procefs which makes the inner ankle. 

8 The upper end of the fibula. 

9 The lower end which makes the outer ankle. 

10 The outfide of the patella. 

1 1 The infide of the patella. 



TAB. IX. 



(58 ) 

TAB. IX, 

1 Aftragalus. 

2 Os calcis. 

3 Os naviculare. 

4) ^3 6, Offa cuneiforma, 

7 Os cuboides. 

8 The five bones of the metatarfm. 

9 The two bones of the great toe. 
|0 The three bones of the kller toes. 



T A B» %* 



TAB .IX. 



P. 5$. 




P-59- 




(59) 

TAB. X. 

A fceleton of an adult pat into this poflure to 
fliew it in a greater fcale. It was thought better 
not to figure it, all thefe bones being explained in 
former plates, and the defign of this being to Tnew 
them together without being defaced with refer- 
ences. 



THE 



(6i ) 



THE 



ANATOMY 



OF THE 



Human Body. 



BOOK II. 

CHAPTER I. 

IntroduBion to the mufcles, 

HE mufcles are moving powers, applied 
to perform the fevera! motions of tlie bo- 
dy ; which they do by contrading their 
lengih, and thereby bringing the parts to which 
they are fixed nearer together. The immoveable 
or leail moved part any mufcle is fixed to, is ufual- 
ly called its origin, and the other its infertion ; 
but mufcles that have their tv/o ends equally liable 
to be moved, may have either called their origins 
or infertions. 

Each 




62 INTRODUCTION 

Each mufcle is made up of a number of fmall 
fibres, which Borelli and others have thought 
to be ftrings of bladders, and have endeavoured to 
account for mufcular motion by an expanlion made 
from an influx of blood and animal fpirits into thefe 
bladders -, but as the mufcles do not increafe their 
bulk fenfibly in contrading, there needs no more 
to be faid to refute this hypotheiis. But another 
great author thought that in this way the mufcles 
might be contraded by a fwelling, fcarce fenfible, 
if the bladders were but very fmall : For, fays he, 
fuppoiing a bladder of any determined bignefs can 
raife a weight a foot, a hundred bladders, whofe 
diameters are each a hundredth part of the former, 
will raife the weight to the fame height. But the 
force of inflation and the fwelling of all together 
will be ten thoufand times lefs, and it will alfo 
raife ten thoufand times lefs v/eight, which he has 
not obferved -, therefore not one fuch firing of blad* 
ders, but ten thoufand muft be applied to do the 
fame thing that the one bladder will do ; and they 
will have the fame fwelling, other wife it would be 
eafy to {hew how to make a perpetuum mobile of 
almoft any force. 

The mufcles are of two forts, viz. reSilineal, 
and pcnniform. The former have their fibres al- 
moft parallel in the fame or near the fame diredion 
with the axis of the mufcle 5 and the latter have 
their fibres joined, in an oblique diredion, to a ten- 
don paffingin or near the axis, or on their outfide. 

The 



TO THE MUSCLES. 63 

The redilineal mufcles, if their origins and in- 
fertions are in little compafs, are never of any con- 
fiderable thicknefs, unlefs they are very long, be- 
caufe the outward fibres would comprefs the inner 
ones, and make them almoft ufelefs 3 and there- 
fore every rectilineal mufcle, whofe inner fibres 
are compr eiTed by the outer, have their inner fibres 
longer than the external, that they may be capable 
of equal quantity of contradlion. 

The penniform mufcles, though *they are in a 
manner free from the inconvenience of -one fibre 
comprefling another, and though by the obliquity 
of their fibres, nothing is abated of their moment, 
(for in all cafes, juil: fo much more weight as redi- 
lineal fibres will raife than oblique ones, the ob- 
lique will move their weight wdth fo much greater 
velocity than the redilineal ; v/hich is making their 
moments equal : fo that in the llrufture of an ani- 
mal, like all mechanic engines, whatever is gained 
in ftrength is loft in velocity, and whatever is gain- 
ed in velocity is loft in ftrength) yet the fibres of 
the penniform mufcles becoming more and more 
oblique as they contract, their ft-rength decreafes, 
.and their velocity increafes, which makes them lefs 
uniform in their actions than the redtilineal muf- 
cles 5 wherefore it feems that ijature never ufes a 
penniform mufcle where a redilineal mufcle can 
be ufed ; and the cafes in which a rectilineal muf- 
cle cannot be ufed, are where the fliape of a muf- 
cle is fuch as that the inward fibres would be too 

much 



64 INTRODUCTION 

much compreffed, or where redilineal fibres could 
not have a lever to ad v^^ith, fuitable to their quan- 
tity of contradion, which is the cafe of all the 
long inufcles of the fingers and toes. For every 
mufcle mull be inferted or pafs over the cen- 
tre of motion of the joint it moves, at a diftance 
fuitable to its quantity of contradion, and the 
quantity of motion in the joint moved 3 for if it 
was inferted too near, then the motion of the joint 
would be perform.ed before the mufcle is contrad- 
ed all that it can 5 if too far off, the miufcle will 
have done contrading before the whole motion of 
the joint is made. And though the quicknefs and 
quantity of motion in a mufcle will be, cseteris pa- 
ribus, as the length of its fibres; (for if a fibre four 
inches long will con trad one inch in a given time, 
a fibre eight inches long will contrad two inches 
in the fame time -, and the ftrength of a mufcle 
or power to raife a weight, cseteris paribus, will 
be as the number of its fibres 3 for if one fibre 
will raife a grain weight, twenty fibres w^ill raife 
twenty grains : ) neverthelefs, two mufcles of 
equal magnitude, one long, and the other fhort, 
will both move the fame weight with the fame ve- 
locity v/hen applied to a bone ; becaufe the levers 
they ad with muft be as their lengths, and there- 
fore the penniform and fliort thick mufcles are ne- 
ver applied to a bone for the fakeof ftrength, nor 
long fibred mufcles for quiclcnefs -, for whatever is 
gained by the form of the mufcle, whether ftrength 

4 or 



T O T H E M U S C L E S. 65 

or quicknefs, muft be loft by their infertions into 
the bone, or elfe the mufeles muft not adt all they 
can, or the bones have lels motion than they are 
made for. . 

In the limbs feveral mufeles pafs over two 
joints, both of which are liable to move at once, 
with foice proportionable to the levers they adt 
with upon each joint 5 but either joint being fixed 
by an antagonift mufcle, the whole force of fuch 
mufeles will be exerted upon the other joint ; 
which in that cafe may be m.oved wich a velocity 
equal to what is in both joints, when thefe mufeles 
ad: upon both at once. This mechanifm is of 
great ufe in the limbs, as I £hall fhew in the pro- 
per places. 

That only we call the proper ufe and action 
of any mufcle which it has v/ithout the neceffary 
affiftance of any other mufcle, and what that is 
in a mufcle moving a joint we may always know 
in any fituation, and with what force it ad:s, ex- 
teris paribus, by dropping a line, from the centre 
of motion of the joint it moves, perpendicular into 
the axis of the mufcle ; but in a joint which ad- 
mits only of flexion and extenfion, this line muft 
alfo be perpendicular to the axis of motion in that 
joint, and the adion of the mufeles will be in the 
direction of that perpendicular line, and the force 
with v/hich it adts in any fituation will be, cseteris 
paribus, as thje length of that perpendicular line. 

E Each 



66 INTRODUCTION, &c. 

Each mufcle, fo far as it is diftindl and is mov- 
ed againft any part, is covered v^ith a fmooth 
membrane to make the fridion eafy -, but where 
they are externally tendinous, thofe tendons are of- 
ten fmooth enough to make fuch a covering need- 
lefs. Beiides this membrane there is another, 
known by the name of fafcia tendinofa, which de- 
fcrves to be particularly confidered. The ftrong 
one on the outfide of the thigh, which belongs to 
the fafcialis and gluteus mufcles, is of great ufe in 
raifing the gluteus farther from the centre of mo- 
tion of the joint it moves, to increafe its force : in 
like manner the fafcia detached from the tendon 
of the biceps cubiti alters its diredion for the fame 
purpofe, but thofe on the outfide of the tibia and 
cubit, &c, are only flat tendons from which the 
fibres of the mufcles arife as from the bones. There 
,are alfo in many places fuch tendons between the 
mufcles, from which each mufcle arifes in like 
manner, for the bones themfelves are not fufficient 
to give origin to half the fibres of the mufcles that 
belong to them; befides, if all the fibres had rife 
from the bones, they muft have been liable to com- 
prefs one another very inconveniently. 



CHAPTER 



OF THE MUSCLES. 67 

CHAPTER II. 

Of the miifcles. 

OBLIQJJU3 DESCENDENS arifes flefhy from 
near the extremities of the eight inferior 
ribs, the upper part of its origin being indented 
with the ferratus major anticus, and the lower ly- 
ing under a fmall portion of the latiffimus dorli. 
It is inferted fiefhy into the upper part of the fpine 
of the ilium, and by a broad flat tendon (which 
firmly adheres to a Hke tendon of the following 
mufcle as they pafs over the redus) into the os pu- 
bis, and linea alba, which is a firong tendinous line 
extended from the o^ pubis to the fternum, between 
th^e mufculi redi. 

Obliq^us ascendens arifes flefhy under the 
former mufcle from the fpine of the ilium, and is 
inferted flefhy in the cartilages of the three loweft 
ribs, and by a flat tendon into the fternum, and 
linea alba, together with the tendon of the forego- 
ing mufcle. The line in which thefe two tendons 
join on the outfide of the rectus mufcle, is called 
femilunaris : and though fo much of this mufcle as 
is inferted flefhy runs obliquely upward, yet the 
middle and lower part is direded tranfverfe and 
downward ; and befide the tendon, Vv hich it unites 
with the obliquus defcendens, it often detaches an- 
other near the fternum to be inferted with the tranf- 
verfalis under the redlus. 

E 2 Pyra- 



68 OF THE MUSCLES. 

Pyramidal IS arifes from the os pubis, and 
is inferted into the linea alba about three or four 
inches below the navel : this and its fellow are of- 
ten wanting. 

Rectus arifes tendinous from the os pubis, 
but flefhy when the pyramidales are wanting, and 
is inferted into the lower part of the flernum, near 
the cartilago enfiformis. This mufcle is divided in- 
to four or five portions by tranfverfe tendinous in- 
terfedions, that it might conveniently bend when 
the body is bowed forwards, though this mufcle 
fhould be then in adtion 5 and thefe interfedions are 
chiefly above the navel, where it is moft liable to 
be bent : befides being thus divided, its chief pref- 
fure will not be in its middle, but under the feve- 
ral bellies of the mufcle, and the greateft below the 
navel, where is the longeft flefhy belly of this muf- 
cle, and where the parts in the abdomen feem to 
want moft to be fupported. 

Transversalis arifes by aflat tendon from 
the tranfverfe proceflTes of the lumbal vertebrae, and 
flefhy from the infide of the ribs below the dia- 
phragm, and from the fpine of the ilium ; then, be- 
coming a flat tendon, it pafies under the redtus to 
its infertion into the linea alba. Between this ten- 
don and the peritoneum fometimes water is found 
in great quantities, which diftemper is called the 
dropfy in the duplicature of the peritoneum > which 
(hews this membrane has been miftook for part of 
the peritoneum. 

'T^HESE 



OF THE MUSCLES. 69 

These five pair of mufcles all confpire to com- 
prefs the parts contained in the abdomen. The ob- 
liquus defcendens on the right fide, and afcendens 
on the left ading together, turn the upper part of 
the trunk of the body towards the lefr, and vice ver- 
fa 5 but the trunk is chiefly turned upon the thighs; 
the redi bend the body forward, and pull the fter- 
num downward in expiration -, the two oblique 
mufcles and the tranfverfe on each fide near the 
groins, are perforated to let through the procefllis 
vaginalis with the fpermatic vefl^els, Thefe perfo- 
rations are diflant from each other, fo as to fufi:er 
the veflels to defcend conveniently into the fcro- 
tum : this way the inteftines or the omentum de- 
fcend in ruptures. 

Cremaster testis is a fmall portion of 
fibres which arifes from the ilium, and appears to 
be part of the obliquus afcendens mufcle, 'till it 
meets with the fpermatic veflTels at their coming out 
of the abdomen, where it begins to defcend with 
them by the fide of the procefilis vaginalis, to the 
tefticle, over which it is loofely expanded. This 
mufcle is too fmall to be plainly difcovered in ema- 
ciated bodies. 

Erector penis arifes from the os ifchium, 
and is inferted into the cms penis near the os pubis. 
It is faid, by prefiing the penis againfl the os pubi? 
to comprefs the vena ipfius penis, and hinder the 
reflux of blood, v/hereby the penis becomes ex tend- 

E 3 <:d 



70 OFTHEMUSCLES. 

ed and eredl ; bat it does not appear to me to be 
well contrived for that ufe. 

Accelerator urin^. This, v^^ith its fel- 
low are but one mufcle. It arifes tendinous from 
the offa ifchia, and flefhy from the fphindler ani j 
or, according to Mn Cowper, from the fuperior 
part of the urethra as it paffes under the os pubis : 
and thence being expanded over the bulb of the 
urethra, it afterwards divides, and is inferted into 
the penis. The ufe of this mufcle is not to accele- 
rate the urine, for that is propelFd by the detrufor 
urinas, or mufcular coat of the bladder, but to pro- 
trude the femen, which is done only by this 5 and 
it being feated oppoiite to the os pubis, it feems to 
be much better fitted to be a relaxer of the penis 
by pulling it fi'om the os pubis^ than the ereiflor is 
for the ofBce afligned it. 

Transversalis penis is that part of the 
former mufcle which arifes from the offi ifchia. 

Sphincter vEsiciE urinari^e is a fmali 
portion of mufcular fibres, not eafily to be diitin- 
gui(hed, running round the neck of the bladder to 
prevent the involuntary eifufion of urine. 

Detrusor urin^ is the mufcular coat of 
the bladder j its fibres are differently difpoled , but 
chiefly terminating in the fphinder veficas, whereby 
it not only preffes the urine forward, but, when the 
bladder is full, becomes an antagoniil to the 
fphin,£ler, adling almoft at right angleSp 

Ere^ 



i 



..^^ 



OF THE MUSCLES. 71 

Erector clitoridis arifes from the if- 
chium, and is inferted into the crus clitoridis, like 
the erecSor penis in men, and is faid, to caufe 
eredion in the fame mannen 

Sphincter vAGiNiE is an order of mufcu- 
lar fibres intermixed with mem.branous fibres fur- 
rounding the vagina uteri near its orifice ; it is con- 
nected to the offa pubis and fphindler ani -, its ufe 
is to conftringe the orifice of the vagina, to prefs 
out a hquor from the glands of the vagina, and 
embrace the penis in coition. 

Dr. Douglas mentions two pair of mufcles of 
the vagina of his own difcovering, which I have 
never difledled, and will therefore give them in his 
own words; " The firft arifes from the inner edge 
*' of the OS pubis mid-way between the ifchion and 
" the beginning of the crus clitoridis, is inferted 
*' into the vagina ; the fecond arifes tendinous and 
*' flelliy from the os pubis internally in common 
*' with the levator ani, is inferted into the upper 
" part of the vagina at the fide of the meatus uri- 
" narius or collum veficas." 

Sphincter ani is a mufcle near two inches 
in breadth, furrounding the anus to clofe it, and 
to prevent involuntary falling out of the fasces. 

Levator ani, by Dr. Douglas called two 
pair of mufcles, but Mr. Cowper defcribes the 
w^hole as one mufcle only, which arifes from the 
offa ifchii, pubis, and facrum within the p^s, 
and is inferted round the lower end of the redum 
inteftinum. E 4 Fistu- 



72 O F T K E M U S C L E S. 

Fistula in ano, that are within this miifcle, 
generally run in the diredion of the gut, and may 
be laid open into the gut with great fafety ; but 
thofe fiilulcB, or rather abfceffes that are frequently 
formed on the outfide of the fphindler, and ufually 
furround it, all but where this mufcle is conne^fted to 
the penis, cannot be opened far into the gut, v/ith- 
out totally dividing the fphinder, which, authors 
fay, renders the fphindter ever after uncapable of 
retaining the excrement. One inftance of this kind 
I have known 5 but Mr. Berbeck of York, an 
excellent furgeon, and particularly famous for this 
operation, has afiared me, that he has often been 
forced to divide the fphinder, which has made the 
patients unable to hold their excrements during their 
cure, but the wounds being healed, they have re- 
tained them as v/ell as ever. 

CoccYGEi arife from the acute proceffes of the 
offa ifchii, and are inferted into the os coccygis, 
which they pull forward. 

OcciPiTO-FRONTALis, IS a mufclc w^ith four 
fiefliy bellies, commonly named frontales and occipi- 
tales. It arifes behind each ear from the os occi- 
pitis, and foon becoming tendinous, pafTes under 
the hairy fcalp to the forehead, where it becomes 
broad and fle&y, adhering to the fkin, and is in- 
ferted into the upper part of the orbicular mufcies 
of the eyelids into the os frontis near the nofe, and 
by two proceffes into the bones of the nofe. When 
this miifcle afts from tte back part^ it pulls the 

fkin 



OF THE MUSCLES. 73 
ficin of the forehead upward, and wrinkles it tranf- 
verfe, and in fome perfons the hairy fcalp back- 
wards ; but when the forepart of it ads, it draws 
theikin with the eyebrows downward, and towards 
the nofe when we frown. The tendon of this muf- 
cle has been miftaken for a men^brane, and been 
called pericranium, and the true pericranium, pe- 
riofteum. 

Elevator auricula arifes from the ten- 
don of the occipito-fron talis, and is inferted into 
the upper part of the ear that is connedled to the 
head. 

Retractor auricula arifes by one, two, 
or three fmall portions from the temporal bone 
above the mammillary procefs, and is inferted into 
the ear to pull it backward. 

Orbicularis palpebrarum furrounds the 
eyelids on the edge of the orbit, and is fixed to the 
futura tranfverfalis at the great corner of the eye ; 
it (huts the eyelids, efpecially in winking. That 
part of this mufcle that lies under the eyebrow is 
very much intermixed with the occipito-fron talis; 
and under it from the os frontis near the nofe, 
arifes a fmall portion of diftind: fibres which end in 
this mufcle, and, I think, are apart of it; never- 
thelefs, from the efFed of their adion, are not im- 
properly called mufculus corrugator. 

Ciliaris is a very fmall portion of this muf- 
cle, ne^t the ciliary cartilages of the eyelids. 

Ele- 



74 OF THE muscles; 

Elevator palpebr^ superioris rec- 
tus riles above the optic nerve, from the peri- 
ofleum at the bottom of the orbit, as do alfo the 
five following mufcles, and is inferted into the 
whole ciliary cartilage of the upper eyelid by a very 
thin flat tendon. 

Elevator oculi arifes from the bottom of 
the orbit, between the optic nerve and the forego- 
ing mufcle, and is inferted in the upper part of the 
tunica fclerotis of the eye, near the cornea. 

Depressor oculi arifes, and is inferted di- 
rectly oppofite to the laft defcribed mufcle. 

Adductor oculi arifes from the bottom of 
the orbit, near the optic nerve internally, and is 
inferted into the tunica fclerotis on the fide next 
the nofe. 

Abductor oculi has both its origin and in- 
fertion diredlly oppofite to the addudor. 

Obliquus superior feu trochlearis a- 
lifes between the elevator and adduftor oculi at the 
bottom of the oi-bit, thence afcending by the fu- 
tura tranfverfalis, becomes a round tendon, which 
pafling through a pulley at the upper and inner 
part of the orbit near its edge, is inferted near the 
bottom of the globe of the eye, which it pulls up- 
ward and inward, and thereby dired:s the pupil 
outward and downward. 

Obliquus inferior arifes from the os max- 
ills fuperioris, at the edge of the orbit 5 thence 
pafTmg over the deprelTor is inferted near the ab- 

dudor 



OF THE MUSCLES. ys 

du6lor at the bottom of the eye, but not fo low as 
the infertion of the obliquus {uperior : it turns the 
popil upward and outward. 

These aiufcles are inferted with great advan- 
tage to move a fmall weight, and are very long, 
that the eye may be moved with fufiicient quick- 
nefs. The two oblique mufcles are an axis to the 
motions of the o^her four, and ading ftrongly a- 
gainft them, which adion I take to be what is vul- 
garly called flraining the eye, may, I think, bring 
the cryftalline humour nearer to the retina, and 
poffibly may make the cryftalline humour more 
flat to fit the eye for objedls at a great diftance. 
For this end it feems to m.e that there are fix muf- 
cles thus difpofed, when three might be fufiicient 
to turn the eye every way, if it was in a proper* 
fixed focket ; and it feems alfo that while the muf- 
cles are all thus in adion, the fuperior oblique in 
each eye fets the pupil farther from the nofe, while 
the inferior oblique direds it upward ; the firft of 
which adions is always necefiTary, and the latter 
often fo, when we look with both eyes at very di- 
flant objeds ; and when the two oblique mufcles 
grow weak by age or difeafe, or ceafe to ad at all, 
as in paralytic cafes, and death, then the eye finks 
in the orbit. 

Sphincter or constrictor oris furrpunds 
the mouth about three fourths of an inch broad. 
This mufcle is very much intermixed with all the 
mufcles that are inferted into it, 

Ele- 



76 OF THE MUS CLES/ 

Elevator labii superioris proprius 
arifes from the bone of the upper jaw under the 
anterior and inferior part of the orbicularis palpe- 
brarum, and ufually takes another fmall beginning 
from the os mate, which feems as if it was fent off 
from the orbicularis palpebrarum 3 and paffing 
down by the fide of the nofe, into which it fends 
fome fibres, is inferted into the upper part of the 
fphinder oris. This raifes the upper lip, and helps 
to dilate the noflrils. 

Depressor labii superioris proprius 
is a fmall mufcle arifing from the upper jaw, near 
the dentes inciforii, and is inferted into the upper 
part of the lip and root of the cartilages of the nofe ; 
hence it is alfo a deprefTor of the nofe, which ac- 
tion conflrifts the noflrils. 

Depressor labii inferioris proprius 
arifes broad from the lower jaw at the chin, and is 
foon inferted into the fphinder oris ; the order of 
fibres in this feems not fo confpicuous as in the 
other mufcles of the face. 

Elevator labii inferioris proprius 
arifes from the lower jaw, near the dentes inciforii, 
and is inferted into the lower part of the lip. 

Elevator labiorum communis arifes 
from a deprelTed part of the fuperior maxilla under 
the middle of the orbit, and is inferted into the 
fphinder mufcle near the corner of the mouth. 

Depressor communis labiorum arifes. la- 
terally from the lower jaw near the chin, and is 

inferted 



OF THE MUSCLES. jj 

inferted into the fphinder, oppofite to the former. 

Zygomatic us arifes from the anterior part 
of the OS zygoma or malae, and frequently derives 
a portion of fibres from the orbicularis palpebrarum, 
thence running obliquely downwards. It is inferted 
into the fphinder at the corner of the mouth, be- 
twixt the elevator communis and buccinator ^ it 
draws the corner of the mouth outward and up- 
ward. When this mufcle grows weak, the corner 
of the mouth finks, as may be obferved in old 
perfons. 

Buccinator arifes from the proceffjs coronas 
of the lower jaw, and paffing contiguous to both 
jaws, is inferted into the fphinder mufcle at the 
corner of the mouth. It ferves either to force 
breath out of the mouth, or thru ft the aliment be- 
tween the teeth in maftication, or jto gull. the cor- 
ner of the mouth outward. - c 

Platysma myoides arifes loofely from over 
the pedoral and part of the deltoid mufcle, and 
running obliquely forward, is inferted into the 
chin, and depreflbr mufcles of the lips. This muf- 
cle being exceeding thin, a mere membrana carno- 
fa, ferves to cover the unequal fnrface of the fub- 
jacent mufcles, and render the neck even ; it alfo 
pulls down the corner of the mouth, and, from its 
infertion at the chin, may contribute to the pulling 
down of the lower jaw. 

Retractor al-^ nasi is a very fmall muf- 
cle arifmg from the bone of the nofe, and is infert- 
ed 



78 OF THE MUSCLES. 

ed into the fkin and cartilage at the fide of the 
nofe. 

Mylohyoideus with its fellow, may be e- 
fteemed one pennifoim or elfe a digaftric mufcle. 
It arifes from the linea afpera on the infide of the 
lower jaw and proceffiis innominatus, both fides 
meeting at about right angles in a middle line up- 
on the following mufcles. It is inferted by a fmall 
portion of fibres into the bafis of the os hyoides ; 
it moves the tongue upward and forward, and alfo 
compreflfes the following mufcles, whereby they 
raife the tongue more commodioufly, and alfo hin- 
ders them from drawing the bafis of the os hyoi- 
des into a right line betwixt the chin and fternum 
at fuch times as the fiylohyoidei cannot ad:. 

Geniohyoideus arifes from the proceflTus in- 
nominatus of the lower jaw, under the foregoing 
mufcle, and is inferted into the bafis of the os hy- 
oides, which it pulls upward and forward. This, 
with its fellow, are for the moft part but one 
mufcle. 

Stylohyoideus arifes from the procefilis fi:y- 
liformis near its root, and palling contiguous to the 
horn of the os hyoides becomes inferted laterally 
into its bafis. This mufcle is fometimes perforated 
about the middle by the tendon of the digaftrie 
' mufcle of the lower jaw. Its ufe is to pull the os 
hyoides up and backward. 

CoR acohyoideus arifes from the upper cofta 

of the fcapula near the proceffus coracoides, and 

I P^ffij^g 



OF THE MUSCLES. 79 

pafling under the mafloideus mufcle becomes in 
that place a round tendon -, thence palling almoil 
parallel to the following mufcle, is inferted toge- 
ther with it into the bafis of the os hyoides ; this 
draws the os hyoides dov/nward, and a little back- 
ward. I have once feen one of thefe mufcles 
wanting, and the fternohyoideus ariiing from the 
middle of the clavicle on that fide. 

Stern OH Yo IDE us arifes from a roughnefs at 
the under part of the clavicula near the ilernum, 
and the cartilaginous part of the firft rib 3 and is 
inferted into the bafis of the os hyoides, to pull it 
downward. 

Genioglossus arifes from the procefliis in- 
nominatus of the lower jav^, and is inferted broad 
into the under part of the tongue, to pull it up 
and forward, and fometimes has a fmall infertion 
into the os hyoides. 

Basioglossus feems a portion of the former 
mufcle ; it arifes from the bafis of the os hyoides, 
and is inferted into the tongue nearer its tip. 

Ceratoglossus arifes from the horn of the 
OS hyoides, and is inferted laterally into the tongue 
near its root, to pull it downward and forward. 

Styloglossus arifes from the extremity of 
the proceflTus ftyliformis, and is inferted into the 
tongue near the former to pull it up and backward. 
I have very often found another ftyloid mufcle fo 
inferted, that I cannot tell whether to call it a 
mufcle of the tongue or pharynx. 

The 



8o OFTHEMUSCLES. 

The tongue is a mufcle made of fibres, lon- 
gitudinal, circular, and tranfverfe, fo intermixed as 
bed to ferve its feveral motions. 

Hyothyroideus or Ceratothyroideus 
arifcs from part of the bafis, and the horn of the 
OS hyoides, and is inferted into the lower part of 
the cartilage thyroides, to pull it upward. 

Sternothyroideus arifes from the Infide 
of the fternum, and is inferted with the former 5 
it pulls the thyroid cartilage diredtly downward. 

Cricothyrotdeus arifes from the anterior 
part of the cartllago cricoides, and running ob- 
liquely upward and outward, is foon inferted into 
the Infide of the cartilago thyroides, which it pulls 
towards the cartilago cricoides. Both this mufcle 
and its fellow for the moft part appear double. 

Cricoaryt-^nojdeus posticus arifes from 
the back part of the cartilago cricoides, and is in- 
ferted into the arytasnoides to pull it backward. 

Cricoaryt^noideus lateralis arifes 
laterally from the cartilago cricoides, and is inferted 
laterally into the arytasnoides. This with its fellow, 
pull down each cartilage toward their origin, and 
thereby dilate the rimula. 

Thyroaryt^noideus arifes from the fupe- 
rlor, middle, and inner part of the cartilago thy- 
roides, and is inferted with the former into the 
arytaenoides cartilage to dilate the rimula. Theie two 
laft defcribed mufcles are not naturally divided, and 
therefore ought to be accounted but one mufcle. 

Ary- 



OF THE MUSCLES. 8i 

Aryt^noideus is one fingle mufcle, which 
arifes from one arytsnoidal cartilage, and is inferted 
into the other to draw them together, and clofe the 
rimula. Thefe few fmall mufcles of the tongue and 
larynx, with only one pipe, make a greater variety 
of notes and founds than can be made by artificial 
inftruments, and that in a manner fo little under- 
fcood by us, and by organs fo little differing from 
thofe in quadrupeds, that, for ought we know of 
them, brutes might be as capable of all thcfe founds 
as men. 

Stylopharyng^us arifes from near the bot- 
tom of the proceffus ftyloides of the os petrofum, 
and running obliquely downward, is inferted into 
the pharynx. This mufcle with its fellow, pulls up 
and dilates the pharynx to receive the aliment. 

Oesophageus arifes like a wing from feveral 
parts of the fcull, tongue, os hyoides, the cricoid 
and thyroid cartilages, and is inferted into the pha- 
rynx* This, with its fellow, conftringe the pha- 
rynx, and prefs the aliment down the gullet. 

MuscuLUs VAGINALIS GuLJB is the muf- 
cular coat of the gu!a. 

Pterygopharyngjeus is not adiftind muf- 
cle, but the beginning of the pharynx near the pro- 
cerus pterygoides of the fphenoidalbone. 

Pterygostaphylinus internus arifes 
from the os fphenoides, near the iter ad palatum, 
or euftachian tube, and is inferted into the uvula, 

F which 



8a O F T H E M U S C L E S. 

which it pulls op while v/e breathe through the 

mouth, or fwallow. 

Pterygostaphylinus externus arifes by 
the fide of the laft defcribed mufcle, and is alfo 
ioferted near it 5 but becomes its antagonift by be- 
ing reflefed 011 a pulley, over a procefs at the 
lower part of the pterygoidal proceffes of the fphe- 
noidal bone. 

Glosso-Staphylinus is a very fmall por- 
tion of mufcular fibres which pafs from the tongue 
to the palate, which it pulls down when we breathe 
through the nofe. 

The palate itfelf is a fort of double mufcle, 
whofe adion feems only to fupport itfelf and aflift 
thofe mufcles which pull it upwards. 

DiGASTRicus arifes from the finus of the ma- 
millary procefs of the os temporis, and from a fiefliy 
belly, becoming a round tendon, paffes through, 
and fometimes under the ftylohyoideus mufcle 5 
and then being tied down by a ligament to the os 
hyoides, grows flefliy, and is fo inferted into the 
anterior part of the lower jaw internally. This 
mufcle's diredlion being altered by its being tied to 
the OS hyoides, where it makes an angle, and not 
at its paffage through the flylohyoideus, pulls the 
lower jaw downward with much greater force 
than other wife it could have done ; and being con- 
rieded to the os hyoides, when it ads, it prevents 
the adlion of feveral mufcles which are concerned 
in fwallowing j w^hence it is that v\^e cannot fwal- 
low 



TO THE MUSCLES. 83 

low at the fame time that we open the jaw, as 
thofe brutes can whofe digaftric mufcles are not 
conneded to that bone. 

Temporalis arifes from the os frontis, parie- 
tale, fphenoides, malse, and temporis, and, palling 
under the two proceffes named os jugale, is inferted 
externally into the proceffus coronalis of the lower 
jaw, which it pulls upward. This mufcle is co- 
vered with a ftrong tendinous fafcia. 

Masseter arifes from the lower edge of the 
OS malas or zygoma, and the procefs which joins 
this from the temporal bone, and is inferted to the 
outer part of the angle of the lower jaw, which it 
pulls up and forward. Thefe two laft defcribed 
mufcles having different diredions, when they aft 
together, make a fteddy motion in the diagonal of 
their diredtions, 

Pterygoideus internus arifes from the 
procefliis pterygoideus externus, and from the finus 
between the pterygoid proceiTes, and is inferted in- 
ternally into the angle of the lower jaw, which it 
pulls upward. 

Pterygoideus externus arifes from the os 
maxillare and os fphenoides, near the root of the 
external pterygoid procefs, and is inferted internally 
into the proceiTus condyloides of the lower jaw, 
which it pulls to one fide, and forwards, or adling 
with its fellow pulls the jaw directly forward. 

SuBCLAvius arifes from the fu per lor part of 
the firft rib, and is inferted into more than half the 

F 2 underfide 



84 OF THE MUSCLES. 

underfide of the clavicula next the fcapula. Its ufe 
is to draw the clavicula toward the fternum, that 
they may not be fevered in the motions of the 
fcapula. 

Trapezius arifes from the os occipltis, and 
from a linea alba colli, from the fpinal procefs of 
the laft vertebra of the neck, and the ten upper- 
rnoft of the back, and from a linea alba between 
all thefe procefies ; and is inferted into one third of 
the clavicle next the fcapula, almoft all the back 
part of the fpine of the fcapula, and as much of 
the proceiTus acromion as lies between the fpine of 
the fcapula and the clavicle. This mufcle draws 
the fcapula diredly backward. 

It is generally faid by authors, that the feveral 
parts of this mufcle aft at different times, and fo 
pull the fcapula different v/ays, as obliquely up- 
ward, downward, or backward ; but, I think, if 
that happened, it muft neceffarily divide this muf- 
cle into diftind: portions, thofe that contrad always 
feparating from thofe that do not. 

Rhomboides arifes tendinous under the former 
from the fpinal procefs of the inferior vertebra of 
the neck, part of the linea alba colli, and from the 
fpinal proceffes of the four or five uppermoft ver- 
tebra of the thorax, and is inferted into the bafis 
of the fcapula, which it pulls up and backward. 
The upper part of tliis mufcle arifing from the 
neck, is in many bodies, by the motions of the 
,^eck, feparated and made a diftinft mufcle, 

4 Ele^ 



O F T H E M U S C L E S. S^ 

Elevator scapula arifes from the tranf- 
verfe procefles of the four fuperior vertebrae of the 
neck, and is inferted into the upper angle of the 
fcapula. 

Serratus minor anticus arifes under the 
pedoralis, from the third, fourth, and fifth ribs, 
and is inferted into the proceflus coracoides fcapu- 
las, which it pulls forward and downward. This 
mufcle is always faid to be an elevator of the ribs, 
though it arifes from the fcapula, which is fup- 
ported by the ribs. 

Serratus major anticus arifes from the 
anterior part of the eight fuperior ribs, and is in- 
ferted into the bafis of the fcapula, which it draws 
forward, and by that means moves the focket of 
the fcapula upward. This mufcle has been always 
accounted an elevator coftarum, though each por- 
tion of it is nearly parallel to the rib it rifes from. 

All the mufcles inferted into the bafis of the 
fcapula are alfo inferted into one another. 

Pectoral IS arifes from near two thirds of the 
clavicula, next the flernum, and all the length of 
the OS pedoris, and from the cartilages of the ribs, 
and is inferted into the os humeri, between the bi- 
ceps and theinfertion of the deltoides. The ufe of 
it is to draw the arm forward. A fmall portion of 
the lower part of this mufcle is often confounded 
with the obliquus defcendens abdominis ; and in 
fome bodies, neither the upper part, nor its tendon, 
can be eafily feparated from the deltoides 5 and in 

F 3 others 



86 OF THE MUSCLES. 

others, even that part of it that arifes from the cla- 
vicala is a diftind portion. Near the infertion of 
this mufcle the fibres crofs thofe from below, end- 
ing above in the arm, and thofe from above be- 
low, that the tendon of this mufcle might not lie 
inconveniently low between the arm and thorax, 
as it would have done had the fibres which arife 
lowefl: from the fternum been inferted loweft in the 
arm ; but this crofiing does not make the tendon 
at all ftronger, as is often faid ; nor can I fee how 
it came to be thought that this tendon lliould want 
more ftrength in proportion than other tendons. 

Deltoides arifes exad:ly oppofite to the in- 
fertion of the trapezius, from one third part of the 
clavicula, from the acromion and fpine of the fca- 
pula, and is inferted tendinous near the middle of 
the OS humeri, which bone it lifts diredlly upward. 
The outermoft parts of this mufcle, when the arm 
hangs down, lie below the centre of motion of the 
joint, and therefore can have no jfliare in lifting the 
humerus up 'till it is raifed part of the way by the 
other part of this mufcle, and the following muf- 
cle^ and as the outer parts of this mufcle begin to 
ad", the following mufcle ads with lefs advantage : 
and it feems to me, that the fole reafon why this 
mufcle is made of To many parts, is, that they 
may a6l independently 3 for it is demonftrable that 
this mufcle, when the whole of it ads, cannot raife 
the arm with fo great advantage as a right lined 
mufcle of the fame magnitude would have done. 

Supra- 



OF THE MUSCLES. 87 

SupRASPiNATus arifes from the dorfum fca- 
puls above the fpine, and paffing between the two 
proceffes, is inferted into the upper part of the os 
humeri, which it helps to raife until it becomes par- 
allel with the fpina fcapula^. 

The fuprafpinatus, the deltoides, and coraco- 
brachialis affift in all the motions of the humerus, 
except depreffion 3 it being neceffary that the arm 
ihould be raifed and fuftained, in order to move it 
to any iide. 

Infraspinatus arifes from the dorfum fca- 
puls below the fpine, and is inferted, wrapping 
over part of it, at the fide of the head of the os hu- 
meri > it turns the arm fupine and backward ; for 
there is a prone and fupine rotatory motion of the 
humerus of near ninety degrees. 

Teres minor is a fmall mufcle arifing below 
the former from the inferior coda fcapuls, and is 
inferted together with it. It aififts the former in 
turning the arm fupine, but pulls it more down- 
wards. 

Teres major arifes fiom the lower angle of 
the fcapula, and is inferted at the under part of the 
OS humeri, about three fingers breadth from the 
head. This draws the os humeri toward the lower 
angle of the fcapula, and turns the arm prone and 
backward. 

Latissimus dor si arifes by a flat tendon 
from the fpinal proceffes of the feven or eight in- 
ferior vertebra of the back, and thofc of the loyns, 

F 4 . facrum. 



83 OF THE MUSCLES. 

facrum, and ilium; and growing flefhy, after it has 
palled the extenfors of the trunk, receives another 
imall fleftiy beginning from the ninth, tenth, and 
eleventh ribs, and is inferted into the os humeri^ 
with the former. This turns the arm backward 
and prone. The tendon of this mufcle ferves for a 
membrane to the extenfors of the back, and is con- 
nected to the tranfverfe proceffes of the vertebrae 
lumborum, 

SuBscAPULARis arifes from the hollow fide 
of the fcapula, which it fills up, and is inferted 
into the head of the os humeri, wrapping fome-^ 
what over it. This pulls the arm to the fide and 
prone. 

CoRACOBRACHiALis arifes from the procef- 
fus coracoides fcapute, in common with the origin 
of one head of the biceps, and is inferted into the 
OS humeri internally about its middle. This raifes 
the arm, and turns it fomewhat outward. 

Biceps cubiti flexor arifes with two heads, 
that the fibres of this mufcle might not comprefs 
one another, one from the procefius coracoides fca- 
pute, in common with the coracobrachialis muf- 
cle, and the other by a round tendon from the edge 
of the acetabulum fcapute, which palling in a ful- 
cus of the 03 humeri, afterward becomes flefliy, 
and joins the nrft head to be inferted with it into 
the tubercle of the radius ; and fom.etimes this 
mufcle has a third head, which arifes from the 
middle of the os humeri. This mufcle lifts up the 

humerus, 



OF THE MUSCLES. 8g 

humerus, bends the cubit, and has as great a fliare 
as any one mufcle in turning the cubit fupine ; the 
humerus being fixed by other mufcles, the whole 
force of this mufcle will be exerted upon the cu- 
bit, or the cubit being fixed by an extenfor, the 
whole force of it will be fpent in raifing the arm, 
and therefore ought to be always reckoned among 
thofe that raife a weight at arms length. A punc- 
ture of the tendinous expanfion of this m.ufcle is 
fuppofed to be always attended Vv^th grievous pain 
and inflammation, and has, if we have not mif- 
taken the caufe, often proved mortal 5 yet many 
eminent fargeons have given inftances of larger 
tendons being cut and ditched, w^ithout any bad 
fymptoms ; and we have often feen them cut, 
torn, ulcerated, and mortified, without any more 
fign of pain than in any other parts. So that lean- 
not fee what the great mifchief of pricking this 
tendinous fafcia is owing to, unlefs its lying fo 
• much upon the ftretch, which may be whol- 
ly avoided by bending the elbow, and turning 
the cubit prone. Since I have confidered this cafe, 
I have met with one who was thus injured by 
an injudicious blood-letter, who ordered the pa- 
tient to keep her arm extended for fear of a con- 
tradion, and fhe was not without the moft violent 
pain for a whole fortnight; but upon bending the 
cubit, and turning the arm prone, (lie grew pre- 
lently eafy, and in a few days, well. Neverthe- 
lefs, I am perfj.adcd that mod of the accidents 

which 



go OF THE MUSCLES. 
which are thought to be merely from blood-lettings, 
are critical difcharges of fome difeafe, and from 
the pundure a fmall inflammation beginning, in- 
creafes and fuppu rates. But however lingular I 
may be thought in this opinion, I can be fure I 
am difinterefted in it, having never had any ill ac- 
cident follow blood-letting in my life. 

Brachi-sus internus arifes from below the 
middle of the os humeri, and is inferted into a 
rough place of the ulna immediately below the 
jundlure. This alfo bends the cubit. 

Supinator radii longus arifes from the 
lower and outer part of the os humeri, and is in- 
ferted into the upper fide of the radius, near the 
carpus. This mufcle is not a fupinator but a bend- 
er of the cubit, and that with a longer lever than 
either of the two former mufcles, and is lefs con- 
cerned in turning the eubit fupine, than either the 
extenforsof the carpus, fingers, or thumb. 

Triceps EXTENSOR cubiti, commonly di- 
flinguiflied into biceps and bracheus externus. The 
firft of thefe heads arifes from the lower cofta of 
the fcapula near the acetabulum ; the fecond from 
the outer and back part of the os humeri 5 the 
third, lower and more internal j and are inferted 
into the proceffiis olecranon of the ulna. The firft 
of thefe heads drawi the arm backward, with as 
long a lever as it extends the cubit. 

Anconjeus arifes from the outward extuberance 
of the OS humeri, and is inferted into the upper 

part 



OF THE MUSCLES. 91 

part of the ulna : this is alfo an extenfor. 

Palmaris longus arifes fmall from the inner 
extuberance of the os humeri, and from a fhort 
belly foon becomes a tendon, which is connedted 
to the ligamentum tranfverfale carpi, and expanded 
in the palm of the hand. This mufcle is often 
wanting, but the expanfion in the hand never; yet 
it being conneded to the ligament of the carpus, 
it muft bend the carpus, and cannot conftridl the 
palm of the hand ; and when it is wanting the 
flexor carpi radialis is larger. 

Palmaris erevis or card qjjadrata 
arifes obfcurely from the ligamentum tranfverfale 
carpi, and feems to be inferted into the eighth bone 
of the carpus and the metacarpal bone of the little 
finger. This helps to conftridt the palm of the 
hand, and is very different in iize in different bo- 
dies. 

Flexor carpi radialis arifes from the 
inner extuberance of the os humeri, and foon be- 
coming a ftrong tendon, paiTes through a channel 
of the fifth bone of the carpus, and is inferted into 
the metacarpal bone of the fore-finger. This not 
only bends the carpus upon the radius, but alfo the 
bones of the fecond order upon thoie of the firfl; 
which motion is nearly as much as that upon the 
radius. 

Flexor carpi ulnaris arifes from the fame 
extuberance with the former, and a fafcia betwixt 
this mufcle and the tenfor ulnaris contiguous to the 

ulna. 



92 OF THE MUSCLES. 

ulna, and is inferted by a fhort tendon into the 
fourth bone of the carpus. 

EXTENSORES CARPI RADIALES ; the firft 

arifes from the os humeri immediately below the 
fupinator radii longus, and is inferted into the me- 
tacarpal bone of the firft finger 5 the fecond arifes 
immediately below this, from the outer extuberance 
of the OS humeri, and is inferted into the metacar- 
pal bone of the fecond finger. The firft of thefa 
mufcles is a bender of the cubit, as well as an ex- 
tenfor of the carpus, and its often ading with the 
benders of the cubit while the other is not m 
action, is the reafon why it is fo difiind: from it. 

Extensor ulnaris arifes from the fame ex- 
tuberance with the former, and half the ulna be- 
low the anconeus mufcle ; then becoming a tendon 
runs in a fmall finus at the bottom of the ulna, 
and is inferted into the metacarpal bone of the lit- 
tle finger. See Ulna, p. 31, 32. Theextenfors of 
the carpus being inferted into the metacarpus, at 
once perform the motion between the bones of the 
carpus, and that between the carpus and radius. 
The flexor and tenfor ulnaris ading together turn 
the hand downward, the tenfor and flexor radialis 
upward. 

Perforatus or flexor secundi inter- 
KODii digitorum arifes from the inner tubercle 
of the OS humeri, and from the upper part of the 
ulna, and the middle of the radius ; then becom- 
iDg four ftrong tendons, paflTes under the ligamen- 

tum 



OF THE MUSCLES. 93 

turn tranfverfale carpi, and is inferted into the be- 
ginning of the fecond bone of each finger. 

Perforans or flexor tertii interno^ 
Dii DiGiTORUM arifes from half the ulna, and a 
great part of the ligament between the ulna and 
radius, then becoming four tendons, paffes undei: 
the ligamentum tranfverfale carpi, and through the 
tendons of the former mufcle to their infertion into 
the third bone of each finger. The tendons of both 
thefe mufcles are tied down to the fingers by a 
flrong ligament. If thefe mufcles had not paffed 
one through the other, the perforatus, which is 
the leffer mufcle, muft have gone to the lafl joint 
where the ftronger mufcle is wanted ; and, befides, 
the tendons of the fecond joints would have pref- 
fed thofe that bend the laft, and not lain firmly 
upon them neither. 

LUMBRICALES Or FLEXORES PRIMI INTER- 

l^ODii DIGITORUM arife from the tendons of the 
laft mentioned mufcle, and are inferted laterally 
toward the thumb into the beginning of the firfl 
bone of each finger. 

Extensor digitorum communis arifes 
from the outer extuberance of the os humeri, and 
pafiing under a ligament at the wrift, is divided 
into four tendons which communicate upon the firft 
joint, which keeps them from Aiding off the joints 
of the fingers, where they are a little connefted to 
the firft bones, and afterward are inferted into ths 
beginning of the fecond bone of each finger. 



94 OF THE MUSCLES. 

Extensor auricularis or minimi di- 
GiTi is a portion of the laft mufcle paffing under 
the ligament in a diftindl channel. 

Extensor indicis arifes from the middle of 
the ulna, and paffing under the ligament of the 
carpus, is inferted with the extenfor communis in- 
to the fore-finger. This mufcle extends the fore- 
finger fingly. I have twice feen it w^anting. 

Abductor primi digiti, interossei, 
and ABDUCTOR minimi digiti, are eight 
mufcles, one for each fide of each finger. Ab- 
dudlor primi digiti arifes from the firft bone of 
the thumb, and the fide of the metacarpal bone 
of the firfl: finger. The interoflei are three pair 
fitly divided into external and internal 5 the exter- 
nal arife from the metacarpal bones, whole fpaces 
they fill up next the back of the hand ; the in- 
ternal arife from the fame bones in the infide 
of the hand. Abdudtor minimi digiti arifes from 
the tranfverfe ligament, and fourth bone of the 
carpus ; thefe mufcles are inferted, two into the 
firft joint of each finger, and then paffing obliquely 
over the tops of the fingers, are inferted into their 
laft bones 5 they bend the firft joints, and extend 
the two laft, as in holding a pen, and in playing 
upon fome mufical inftruments. The abdudors 
of the fore and little fingers, with the fecond 
and fifth interoflei mufcles ading, the fingers are 
divaricated, and the other four ading bring them 
together, and thefe mufcles which divaricate the 

fingers. 



OF THE MUSCLES. 95 

fingers, being extenders of the fecond and third 
joints, we never can divaricate them v^ithout ex- 
tending them a little. 

Adductor ossis metacarpi minimi di- 
git i arifes from the eighth bone and tranfverfe li- 
gament of the carpus, and is inferted into the me- 
tacarpal bone of the little finger, which it pulls to- 
ward the thumb to conflridl the palm of the hand. 

Extensor primi internodii pollicis 
arifes from the ulna below the anconeus mufcle, 
and the ligament between the ulna and radius; 
then becoming two, three, or four tendons, is in- 
ferted into the fifth bone of the carpus, and firft of 
the thumb. The firfl of thefe infertions can only 
affift the bending of the wrift upward, and in turn- 
ing the arm fupine. 

Extensor secundi internodii polligis 
arifes immediately below the former from the ra- 
dius and tranfverfe ligament, and is inferted by a 
few fibres into the fecond bone of the thumb, but 
chiefly into the third. 

Extensor tertii internodii pollicis 
arifes immediately below the laft delcribed, from 
the ulna and ligament, and pafTes over the radius 
nearer the ulna to be inferted at the third bone of 
the thumb. This extends the thumb more toward 
the ulna than the former mufcle, and is very much 
a fupinator. 

Flexor primi et secundi ossis pollicis 
arifes from the fifth bone and tranfverfe ligament 



of 



96 OF THE MUSCLES. 

of the carpus, and from the beginnings of the two 
firft metacarpal bones, and is inferted into the 
whole length of the firfl: bone of the thumb, and 
tendinous into the beginning of the fecond 3 the fe- 
famoid bones of the thumb in fuch bodies as have 
them, lie in this tendon, where it paffes over the 
joint. 

Flexor tertii internodii pollicis 
arifes large from almoft all the upper part of the ra- 
dius, and becoming a round tendon pafles under 
the ligamentum tranfverfale carpi to be inferted into 
the third bone of the thumb. This mufcle fingly 
adling, drav/s the thumb towards the metacarpal 
bone of the little finger 5 bat the laft mentioned 
mufcle ading with it, turns it toward the fore- 
finger. 

Adductor pollicis arifes from the carpus, 
fend almoft the whole length of the metacarpal bone 
of the long finger, and is inferted into the begin- 
ning of the fecond bone of the thumb. This muf- 
cle naturally enough divides into two, and m.ight 
better be called a fiexor than addudor. 

Abductor pollicis arifes from the fifth 
bone and ligamentum tranfverfale of the carpus, 
and is inferted laterally into the beginning of the 
fecond bone of the thumb to draw it toward th§ 
radius. 

The mufcles which bend the thumb are much 
lefs than thofe which bend the fingers ; neverthe- 
lefs, the thumb is alie to refift all the fingers, 

merely 



G F THE MUSCLES. 97* 

merely from the advantages that arife from the 
thieknefs and (hortnefs of the bones of the thumb, 
compared with thofe of the fingers -, but then the 
quicknefs of motion in the fingers will exceed that 
of the thumb, as much as the fingers exceed the 
thumb in length, and their mufcles thofe of the 
thumb in largenefs. 

Supinator radii brevis arifes from the 
outer extuberance of the os humeri and upper part 
of the ulna, and running half round the radius, is 
inferted near its tubercle. 

Pronator teres arifes from the inner apo- 
phyfis of the os humeri, and upper and forepart of 
the ulna, and is inferted tendinous into the radius 
below the former. 

Pronator quadratus arifes from the lower 
edge of the ulna near the carpus, and paffing under 
the flexors of the fingers, is inferted into the radius. 

These mufcles are occafionally aflifted in their 
actions by the mufcles of the hands, the extenfors 
aflifting the fuplnators, and the flexors the prona- 
tors, and mod of the extenfors of the hand take a 
great part of their origin from the tendinous fafcia 
that covers them, 

Mastoideus arifes tendinous from the fler- 
num near the clavicula, and by a feparate flelliy 
portion from the clavicula, which foon unites with 
the other beginning, and is inferted to the outer 
part of the mamillary procefs of the temporal 
bone. It pulls that fide of the head it is inferted 

G into, 



98 OF THE MtJSCLEa 

into, towards the fternum, and turns the face toward 
the contrary fhoalder. This, with its fellow, pull 
the head and neck toward the breaft, and ad with 
a much longer lever upon each lower vertebra, than 
they do upon the next above, and with more power 
upon any of thofe joints than upon the head. This 
mufcle being inferted into the head, beyond the 
centre of motion of the head with the firft ver- 
tebra, has been fuppofed by feveral anatomifts 
to pall the head backward ^ but the paffing be- 
yond figniiies nothing to that purpofe, unlefs a line 
going through its axis would pafs below the cen- 
tre of motion : and it is the more to be wondered 
how this miilake prevailed, if we confider that this 
mufcle's being added to the extenfors of the head 
and neck, would make the force of that adlion a 
hundred times greater than that of the benders. 
And if this is not enough to convince, let any one 
lying on his back raife his head, and he will foon 
feel this mufcle in adion ; but bowing the head 
forward in an eredl pofture will not fhew this, un- 
lefs fome refiftance is made to the head, becaufe 
the centre of gravity of the head lying before the 
centre of motion, there needs no more than a re- 
laxation of the extenfors, to bring the head for* 
ward in that pofture. 

Rectus intern us major arifes from the 
anterior part of the tranfverfe proceffes of the thirds 
fourth, fifth, and fixth cervical vertebras^ and paf- 
fing over the two fuperior, is inferted into a rough- 

nefs 



OF THE MUSCLES. 99 
tiefs of the occipital bone near the fore-part of the 
great foramen. This bends the head on the two 
firfl: vertebras of the neck. 

Rectus minor internus arifes under the 
laft mufcle, from the iirft vertebra, and is inferted 
under it into the os occipitis. This bends the head 
on the fir ft vertebra. 

Rectus lateralis arifes from the anterior 
part of the tranfverfe procefsof the firft vertebra of 
the neck, and is inferted into the os temporis and 
occipitis between the mamillary and ftyloid pro- 
cefles. This turns the head on one fide. 

Splenius arifes by a thin tendon from the fpi- 
nal procelTes of the five fuperior vertebras of the 
thorax, and the loweft of the neck, and linea alba 
colli, and is inferted into the os occipitis, the up- 
per part of the mamillary procefs of the temporal 
bone, and the tranfverfe procefles of the three fu- 
perior cervical vertebrae. This pulls the head and 
neck backward, and to the contrary fide 5 but 
both of thefe afting together pull/the,m diredly 
backward. ja^thi 

Complexus arifes from the tr^nfi^rfe procefies 
of the fix or feven fuperior vertebrse of the thorax, 
and fix inferior of the neck, and is inferted into 
the OS occipitis, and back part of the os temporis ; 
this laft part is fometimes diftinct enough to be ac- 
counted another mufcle : it pulls the head and 
neck back. 

G a Rectus 



,oo OF THE MUSCLES. 

Rectus major posticus arifes from the 
fpinal proceffes of the fecond vertebra of the neck^ 
and is inferted broader into the osoccipitis. It pulls 
the head back on the two firfl vertebras. 

Rectus minor posticus arifes from the back 
part of the firfl: vertebra of the neck, it having no 
fpinal procefs, and is inferted below the former in- 
to the fame bone to pull the head back on the firft 
vertebra. 

Obliquus superior arifes from the tranfverfe 
procefs of the firft vertebra, and is inferted into the 
OS occipitis and back part of the os temporis near 
the redus major; either of thefe ading, afiift the 
recflus lateralis on the fame fide 3 but toth together 
pull the head back. 

Obliquus inferior arifes from the fpinal 

procefs of the fecond vertebra of the neck, and is 

inferted into the tranfverfe procefs of the firfl. This 

with its fellow alternately ading, turn the head 

with the firfl: vertebra in a rotatory manner on the 

fecond, whofe procefiiis dentatus is the axis of this 

motion. - f -^ 

r<^..^,. .rv.^* .,^% , _ 

iNTERSPtNALES COLLI are three or four pair 

of mufcles between the bifid procefiTes of the cervi- 
cal vertebra, which they draw nearer each other 
when the neck is bent backward. 

LoNGus colli arifes laterally from the bodies 
of the four fuperior vertebra of the thorax, and 
from the anterior part of the tranfverfe procefiTes of 
the five inferior vertebra of the neck, and is infert- 
ed 



OF THE MUSCLES. lor 

ed into the fore part of the firft and fecond verte- 
brjE of the neck, which it bends forward. 

Intertransversales colli are portions of 
flefli between the tranfverfe proceffes of the verte- 
bra of the neck, like the interfpinales, but not fo 
diftindt 5 they draw thefe proceffes together. 

Spinalis colli arifes from the tranfverfe pro- 
cefles of the five fuperior vertebrae of the back, and 
is inferted into the fpinal proceffes of the fecond, 
third, fourth, and fifth vertebrae of the neck. This 
pulls the neck backward. 

Transversalis COLLI arifes from the ob- 
lique proceffes of the four inferior vertebras of the 
neck, and is inferted into the fpinal procefs of the 
fecond vertebra of the neck. This mufcle is but 
a continuation of the tranfverfalis or femifpinalis 
dorfi. 

The mufcles of the head and neck are moft of 
them obliquely diredted, which makes them per- 
form the oblique motions, as well as extenfion and 
flexion ; which is highly convenient in this cafe, 
becaufe the joints moved by thefe mufcles, being 
under the weight moved, it is neceffary that the 
head (hould be kept fteddy by the extenfors, and 
flexors too, when any great weight is upon the 
head ; and thefe mufcles from the obliquity of their 
diredlions, not only perform thefe two acftions at 
once, but afting by pairs they move the head and 
neck fl:eddily, in a diagonal diredion, which ftralt. 
mufcles could not have done fo well. 

G 3 ScA- 



302 OF THE MUSCLES. 

Scalenus arifes fl'om the tranfverfe proceffes of 
the fecond, third, fourth, fifth, and fixth cervical 
vertebrae. It is inferted in three parts, into the 
tvi^o uppermoft ribs, being thus divided for the 
tranfmiffion of the fubclavian veflfels. This mufcle 
r/iay bend the neck, but its chief ufe is to fupport 
the upper ribs, which is neceffary to determine the 
contradion of the intercoflal mufcles that way^ 
and a ligament could not have done this, becaufe 
of the various pofitions that the neck and back are 
liable to. 

Serratus superior posticus arifes with a 
thin tendon infeparable from the rhomboides, from 
the fpinal prpcefs of the inferior cervical vertebra, 
and the three fuperior of the thorax, and is inferted 
into the fecond, third, and fourth ribs, imme- 
diately beyond their bendings ; this, with the fca- 
lenus, fuflains the upper ribs, that they might not 
be puird downward by the depreffors of the ribs 
in exlpiration, as the lower ribs are upward in in^ 
ipis^ation. 

Serratus inferior posticus arifes with a 
broad tendon, infeparable from that of the latiffi- 
mus dorfi, from the fpinal proceffes of the three 
fuperior vertebras of the loins, and two inferior of 
the thorax, and is inferted into the tenth rib, but 
chiefly the ninth and eleventh y it pulls down the 
fibs in expiration. 

Intercostales are eleven pair on each fide, 
in the interfaces of the ribs 5 from their fituations 

diftin- 



OF THE MUSCLES. 103 
diftinguifhed into external and internal 3 they all 
arife from the under edge of each rib, and are in- 
ferted into the upper edge of the rib below. The 
external are largeft backward, having their firfl: 
beginnings from the tranfverfe proceffes of the ver^ 
tebrs like diftindl mufcles, which fome call leva- 
tores coilarum. The internal run all from above 
obliquely backv/ard ; being thickefl forward, and 
thinnefl toward the fpine. Thefe are alfo continued 
betwixt the cartilages of the fternum, with fibres 
perpendicular to the cartilages; and between the 
cartilages of the lowed ribs, they are infeparable 
from the obliquus afcendens abdominis. Thefe muf- 
cles, by drawing the ribs nearer to each other, pull 
them all upward, and dilate the thorax, they being 
fuilained at the top by the fcalenus and ferratas 
fuperior pofticus. To thefe Mr. Cowper adds 
fome fle(hy fibres, which run from one rib over a 
fecond to a third, near the fpine, which are leva- 
tores coftarum. 

. Triangularis sterni arifes internally frctn 
the earligago enfiformis, and the lov/er edge of the 
OS pectoris, and is inferted into the end of the third, 
fourth, fifth, and fixth ribs. This pulls the ribs to 
the bone of the flernum, and thereby bends its car- 
tilages in exfpiration. 

Diaphragma arifes on the right fide by a 
procefs from three lumbal vertebrs, and one of the 
thorax ; and on the left, from the one fuperior of 
the loins, and inferior of the thorax 3 this lafi: part 

G 4 being 



104 OF THE MUSCLES. 

being lefs to give way to the great artery, and is 
inferted into the lower part of the fternum and the 
five inferior ribs. The middle of this mufcle is a 
flat tendon, from whence the flefliy fibres begin 
and are diftributed, like radii from a centre to a 
circumference. When this mufcle adls alone, it 
conftrids the thorax, and pulls the ribs downward, 
and approaches toward a plain ^ which adion is ge- 
nerally performed to promote the ejeftion of the 
fseces. In large infpirations, when the intercoftals 
lift up the ribs to widen the thorax, this mufcle 
ads enough to bring itfelf toward a plain without 
overcoming the force of the intercoftals, by which 
means the breaft is at once widened and lengthen- 
ed : w^hen it adls with the abdominal mufcles it 
draws the ribs nearer together, and conftrids the 
thorax, and the fuperior force of the abdominal 
mufcles thrufting the parts of the lower belly againft 
it, it becomes at the fame time convex upward, 
and fliortens the thorax, which occafions the largefl 
exfpi rations ; or ading alternately with the abdo- 
minal mufcles only, a more moderate infpiration 
and exfpiration is made by ihortening and lengthen- 
ing the thorax only, which is what we chiefly do 
^hen lying down ; or ading alternately with the 
intercoftals only, a moderate exfpiration and infpi- 
ration is caufed by the widening and narrov/ing the 
breaft, which is what we are moft prone to in an 
ered pofitlon, the mufcles of the abdomen at fuch 
|imes being employed in fopporting the parts coii- 

tained 



OF THE MUSCLES. 105 

tained in the abdomen. And though thefe mo- 
tions of the ribs require at any one time but very 
little force, the air within the thorax balancing that 
without ; yet that thefe mufcles, whofe motions are 
effential to life, may be never v/eary, the infpirators 
in moft men have force fufficient to raife mercury 
in a tube four or five and twenty inches in an 
eredt pofture, and the exfpirators fix or feven ; the 
firft of which will require about four thoufand 
pound force in moft men, and the other propor- 
tional. But I imagine, that lying down, thefe pro- 
portions will differ by the weight of the parts con- 
tained in the abdom.en. In all the bodies I have 
differed, I have found the diaphragm convex up- 
ward, which gave me occafion to think, that all 
animals died in exfpiration, 'till the forementioned 
experiment difcovered, that the mufcles of infpira- 
tion were flronger than thofe of exfpiration ; which 
ied me to make the following experiment : I cut 
the wind- pipe of a dog, and having a firing ready 
fixed, I put a cork into it, and tied it fafl inflantly 
after infpiration -, upon which I obferved, that the 
diaphragm, and the other mufcles of infpiration and 
exfpiration were alternately contradled and diftended 
for fome time ; but when he was dead, the abdo- 
minal mufcles were in a ftate of contraction, the 
ribs were elevated to dilate the thorax, and the 
diaphragm was convex upward. This experiment 
alfo {hews, that the diaphragm is not a mufcle of 
equal force either tq the deprefibrs or elevators. of 

the 



io6 OF THE MUSCLES. 

the ribs, it neither hindering the elevators frorr^ 
raifing the breaft -, nor the depreffors from thrufting 
it upward, by compreiTing the parts contained in 
the abdomen, though the breaft was full of air. 

Sacer sacrolumbaljs, longissimus 
PORSI, and semispinalis are all that portion 
of fieili betwixt the os facrum and the neck, whichj 
feeing there is no membrane to diftingaifh it inta 
feveral mufcles, and that it is all employed in the 
fame actions, I (hall give it the name of extenfor 
dorfi & lumborum, and defcribe it all as one 
rnufcle. 

Extensor dorsi et lumborum arifes froni* 
the upper part of the os facrum, the fpine of the 
OS ilium, the back parts of the lowermoft vertebra 
of the loins, and remarkably from thofe ftrong ten- 
dons which appear on their outfides. That part of 
this mufcle, which is known by the name of facro- 
lumbalis, is inferted into all the ribs near their arti- 
culations, with the tranfverfe proceffes of the ver- 
tebrae, and into the tranfverfe procefs of the laft 
^vertebra of the neck 5 befides, as this pafles over 
the ribs, it receives an origin from every rib, in a 
i manner that cannot well be defcribed. The portions 
.,;of this mufcle which arife from the ribs, and are 
. inferted into other ribs above, -will neceflaiily draw 
the back part of the ribs nearer together, which 
muft always be done as the back extends, and in- 
dependent of other aftions of the thorax. The 
next portion of this mufcle, called longifiimus dorfi, 

4 is 



OF THE MUSCLES. 107 

is inferted into all the tranfverfe procefies of the 
vertebrae of the back, and partly into the ribs, and 
the uppermofl: tranfverfe proceffes of the vertebra 
of the loins ^ and the upper end of it is neither 
very diftincfl from the complexus of the head, nor 
fpinalis of the neck. The reft of this mufcle, 
known by the names of femifpinalis, facer, &c. 
arifes alfo from all the tranfverfe and oblique pro- 
ceffes of the loins and back ; every portion, except 
the lowermoft, pafling over five joints, is inferted 
into the fpinal procef& of the fixth vertebra above 
its origin, all the vi^ay up the back, and at the 
neck commences tranfverfalis colli. Thispaffingof 
each portion of a mufcle over a few joints, dillri- 
butes their force equally enough among all thefe 
joints, without the fibres being directed more ob- 
liquely than thofe of penniform mufcles ; but the 
neck and loins not having fufficient proviiion of this 
fort, there are fmall mufcles between their procef- 
fes, which, though they are of little importance for 
the motions of thofe parts, yet are fufficient to dif- 
tribute the force of larger mufcles equally among 
thofe joints ; and befides the ufes of the extenfor 
dorfi & lumboram, which its name implies, it and 
its fellow alternately raife the hips in walking, 
which any one may feel by laying his hand upon 
his back. 

Qi^ADRATus LUMBORUM arifes from the up- 
per part of the fpine of the ilium^ and is inferted 
into all the tranfverfe proceffes of the four upper- 
mofl 



io8 OF THE MUSCLES. 

moft lumbal vertebra. This, with its fellow, ad- 
ing alternately, afiift the laft mentioned mufcle in 
raifing the offa innominata in progreffion : or each 
afting fingly, while the lower limbs are not moved, 
inclines the body to one fide. 

Intertransversales lumborum are fmall 
mufcles feated between all the tranfverfe proceffes 
of the vertebra lumborum, to bring them nearer 
together. 

Psoas parvus arifes laterally from the body 
of the firfl: lumbal vertebra, and the loweft of the 
back, and foon becoming a fmall tendon, is infert- 
ed into the os pubis near the ilium. It either af- 
fifts in bending the loins forward, or raifing the c^ 
innominatum in progreffive motions. This mufcfe 
is often wanting. 

Psoas magn us arifes laterally from the bo- 
dies and tranfverfe procefles of the four fuperior 
vertebrae of the loins, and the laft of the back, and 
is inferted with the following mufcle into the lefTer 
trochanter. This bends the thigh, and when the 
pfoas parvus is wanting, this is larger. 

Iliachus internus arifes from the concave 
part of the ilium, and from its lower edge, and 
pafiing over the ilium near the os pubis, joins the 
former mufcle^ and is inferted with it, to be em- 
ployed in the fame acStion. 

Pec TINE us arifes from the os pubis or pedinis, 

near the joining of that bone with its fellow, and 

is- inferted into the linea afpera of the thigh bone, 

j four 



TO THE MUSCLES. 109 
four fingers breadth below the leffer trochanter. 
This bends the thigh and turns the toes outward. 

Triceps femoris, the two leffer heads of 
this mufcle arife under the pedineus, and the third 
from the inferior edges and back part of theos pu- 
bis and ifchium, and is inferted into the whole 
length of the linea afpera and the inner apophyfis 
of the OS femoris. This alfo bends the thigh, and 
turns the toes outward. When the thigh bone is 
moved in a plain which cuts at right angles a plain 
that paffes through the axis of either head of the 
laft mufcle, that head riling lower than the centre 
of motion of the hip joint, it will either alTifl: 
the flexors or extenfors, and that moft when 
the bone has been moved moft backward or for- 
ward ; and as either of thefe heads lie more or leis 
out of the faid plain, they will give greater affifc- 
ance to that motion which is made on the fide of 
the faid plain, contrary to their fituation, and lels 
on the fame fide. This mechanifm is frequently 
made ufe of to make one mufcle fcrve different 
aftionsj but I have only explained it in this in- 
ftance, becaufe it is the moft cpnfiderable one that 
• I know. . -v - -^' 

Gluteus maximus arifes from the back part 
of the fpine of the ilium, and the dorfum ilii, and 
fide of the os coccygis and facrum, and a ligamenf 
extended between thefe bones, and from a thia 
fafcia fpread over that part of the following muf- 
cle, which this does not cover, and is inferted by 



no OF THE MUSCLES. 
a flrong tendon into the upper part of the linea 
afpera of the thigh bone, and alfo into the flat ten- 
don of the fafcialis mufcle, which infertion into, or 
connecftion with, that tendon raifes this mufcle far- 
ther from the centre of motion, and increafes its 
ftrength. This extends the thigh, and both thefe 
together being contracted, occaiionally affifl; the le- 
vatores ani in fupporting the anus. The breadth of 
the origin and infertion of this mufcle is very ob- 
fervable, for by that means, though it is the lar- 
geil: mufcle in the body, if is neverthelefs right-lined 
without one fibre compreffing another any more 
than in penniform mufcles. 

Gluteus MEDiusarifes from all the anterior 
part of the fpina and dorfum ilii, and underpart 
of the laft mentioned mufcle, arid is inferted into 
the upper part of the great trochanter of the thigh 
bone. This extends the thigh outward. 

Gluteus minimus arifes entirely under the 
former, from the dorfum Jlii, and is inferted into 
the upper and anterior part of the great trochanter 
and neck of the thigh bone to extend the thigh. 

Pyriformis arifes internally from the infide 
of the OS facrum, and growing in more than half 
its progrefs into a round tendon, is inferted into the 
upper part of the finus at the root of the great tro- 
chanter. This afTifts fomewhat in extending the 
thigh, but more in turning it outward. 

QjjiiDRATus FEMORis arifes from the obtufe 
procefs of the ifchiam, and is inferted into the up- 
per 



OF THE MUSCLES. iir 

t^er part of the linea afpera of the thigh bone, be- 
tween the two trochanters. This draws the thigh 
inward, and diredls the toes outward. 

Obturator internus or marsupialis 
arifes generally from a flrong menabrane or liga- 
ment, which fills up the hole of the os innomina- 
turn, and from the circumambient bone 5 thence 
paffing over a chanel in the ifchium betwixt its 
two proceffes, it receives from them two other por- 
tions, which are a fort of mariiipium ; and is in- 
fertedinto the finus of the great trochanter. This 
turns the thigh outward. 

Obturator extern us arifes oppofite to the 
former, from the outiide of the os innominatum, 
and is inferted into the finus of the great trochan- 
ter. This alfo turns the thigh outward. Thefe 
four laft mentioned mufcles ading with the exten- 
fors, prevent their turning the toes inward, and in 
llepping forwards are continually acfting to turn the 
toes outwards 5 for though the toes are placed per- 
pendicular to the front of the body, in taking a 
long flep, thefe mufcles bring them perpendicular 
to the fide of the body ; and as thefe dired, the 
fame extenfors will turn the thigh either outward 
or backv/ard, with their full force. 

Fascialis or membranosus arifes ftom the 
fore part of the fpine of the ilium, and in about 
five inches progrefs becomes a flat tendon or fafcia, 
which is joined by a confiderable detachment from 
the tendon of the gluteus maximus^ and from the 

linea 



jiz OF THE MUSCLES. 

linea afpera of the thigh bone, and then covering 
in an efpecial manner the vaftus externus, is inferted 
at the top of the tibia and fibula, and then proceeds 
to join the fafcia, which covers the upper part of 
the mufcles fituate on the outfide of the tibia, and 
from v^hich a great part of the fibres of thofe muf- 
cles arife. About the middle of the leg it grows 
loofe, and is fo continued -^ to the top of the foot^ 
being connected there, and at the lower part of the 
leg, to the ligaments which tie down the tendons. 
This tendon, where it covers the vaftus externus j 
receives additional tranfverfe fibres, which run round 
the thigh, but are moft confpicuous on the outfide. 
This draws the thigh outward, and paffing over 
the knee forwarder than its axis of motion, it will 
help to extend that joint. 

Gracilis arifes from the os pubis clofe to the 
penis, and is inferted into the tibia four or five fin- 
gers breadth below the knee. This draws the thigh 
inward, arid paffing over the knee behind its axis 
of motion, it will help to bend it. 

Sartorius arifes from the fore part of the 
fpine of the ilium, and thence defcending oblique- 
ly to the infide of the tibia, is there inferted four 
or five fingers breadth below the joint. This at 
once helps to bend both the thigh and leg, parti- 
cularly the thigh, at v^ry long levers ; it direftly 
helps to lift up the leg in walking up flairs, or lay- 
ing the legs acrofs like taylors,. 

Semi- 



OF THE MUSCLES. 113 

Semitendinosus arifes from the obtufe pro- 
cefs of the ifchium, and growing a round tendon 
in fomewhat more than half its progrefs, is inferted 
near the former mufcles into the tibia : it helps to 
extend the thigh and bend the tibia. 

Semimembranosus arifes by a flat tendon 
like a membrane from the obtufe procefs of the 
ifchium, and being continued tendinous betwixt 
the bellies of the lafl: mentioned and following muf- 
cles, and then growing fleOiy, becomes again ten- 
dinous above the joint, and is inferted nearer the 
joint than the former mufcle for the fame ufe. 

These two make the internal hamftring, and 
arifing and inferting fo near together, they might 
have been one mufcle, but their fibres would have 
been near tvv^ice as long, which would have given 
a motion near twice as quick, but not fo firong, 
unlefs it had been inferted at a diftance from the 
joint it moves proportionable to its length, which 
could not well be ; therefore they are made two 
mufcles of a number of fibres nearly equal to what 
one could have been, and are inferted at diftances 
from the axis of m.otion of the knee, proportional 
to the diff'erent lengths of their fibres in the direc- 
tions of their axes. 

Biceps tibi^, the firft head arifes in common 
with the two preceding mufcles, from the obtufe 
procefs of the ifchium -, the fecond from the lower 
part of the linea afpera of the thigh bone. This 
foon joins the former, and is inferted with it into 

H the 



114 OF THE MUSCLES. 

the upper part of the fibula to bend the leg, and 
the firft head alfb extends the thigh. The tendon 
of this mufcle makes the external hamftring, when 
the knee is bent , and when we fit down, the biceps 
will turn the leg and toes outward, and the femi- 
tendinofus and femimembranofus will turn them 
inward. 

PoPLiTEUS arifes from the outer apophyfis of 
the OS femoris, and thence running obliquely in- 
ward, is inferted into the tibia immediately below 
its head. This affifls the flexors, and draws the 
tibia toward the outer apophyfis of the thigh bone. 
Rectus tibi^ arifes with a tendon from the 
upper part of the acetabulum of the os innomina- 
tum, and by another tendon, which is a fort of li- 
gament to this, from a proceffus innorainatus of the 
ilium below its fpine forward, and is inferted to- 
gether with the three following mufcles into the 
patella. It bends the thigh and extends the tibia. 

Vastus extern us arifes from the anterior 
part of the great trochanter and upper part of the 
linea afpera of the thigh bone, and is inferted into 
the upper and external part of the patella. It ex- 
tends the tibia. 

Vastus internus arifes from the inner and 
lower part of the linea afpera, and is inferted into 
the upper and inner part of the patella, to extend 
the tibia ; and the fibres of this mufcle being ob- 
lique, it keeps the patella in its place, the other 
mufcles lying in the diredion of the os femoris, 

^ which 



OF THE MUSCLES. 115 

which makes an obtufe angle with the tibia, they 
would alone be liable to draw the patella outward. 
Thi^ contrivance is moft obvious in thofe whofe 
knees bend moft inward. 

Crureus arifes between the two laft below the 
redus, from all the convex part of the os fcmoris, 
and is inferted in like manner into the patella ; the 
patella being tied down by a ftrong ligament to the 
tibia. Thefe three laft mufcles extend the tibia 
only, and might very properly be called extenfor 
tibiae triceps. 

GasterocnExMius arifes by two fmall begin- 
nings above the back part of the apophylls of the 
OS femoris, which foon becoming large bellies 
unite, and then become a flat tendon which joins 
the following mufcles to be inferted into the os 
calcis. The two parts of this mufcle are by fome 
writers diftingui(hed into two mufcles. Its ufe is 
to extend the tarfus and bend the knee. 

Plantaris arifes under the outer beginning of 
the laft named mufcle, from the external apophvfis 
of the OS femoris, and foon becoming a fmall ten- 
don, is fo continued betwixt the foregoing and fub- 
fequent mufcles, and is inferted with them. It 
bends the knee and extends the tarfus. Authors 
derive the tendinous expanlion on the bottom of the 
foot from the tendon of this mufcle 3 but feeing 
the expanfion is much more than this tendon could 
make, and that this tendon can be traced no far- 

H 2 ther 



ii6 OF THE MUSCLES. 

ther than the os calcis, and that the expanfion is 
as large when the mufcle is wanting, which is not 
feldom, I qannot be of that opinion. 

Gasterocnemius internus arifes from the 
upper part of the tibia, and one third of the fi- 
bula below the popliteus, and is inferted with the 
two foregoing mufcles by a ftrong tendon into the 
upper and back part of the os calcis. This muf- 
cle only extends the tarfus. 

Tibialis anticus arifes from the upper and 
exterior part of the tibia, and is inferted laterally 
into the os cuneiforme majus of the tarfus, and by 
a fmall portion of its tendon into the metacarpal 
bone of the great toe. This bends and turns the 
tarfus inward. 

Tibialis posticus arifes firft by a fmall be- 
ginning from the upper part of the tibia between 
that bone and the fibula, then pafling between the 
bones through a perforation in the tranfverfe liga- 
ment which conneds thofe bones, it takes other 
"beginnings from the upper and middle part of the 
tibia, and from the middle of the fibula, and the 
ligament betwixt the tibia and fibula ; then grow- 
ing a round tendon, paffes under the inner ancle, 
and is inferted into the lower part of the os navi- 
culare, and into the os cuneiforme majus. This 
extends and turns inward the tarfus. 

Peroneus longus arifes from the upper and 
outer part of the fibula, and growing a tendon to- 
ward 



OF THE MUSCLES. 117 
ward the lower part of this bone, paffes under the 
outer ancle, and the mufcles fituated on the bot- 
tom of the foot, and is inferted into the beginning 
of the metatarfal bone of the great toe, and the 
OS cuneiforme next that bone. This turns the tar- 
fus outward, and direds the force of the other ex- 
tenfors of the tarfus toward the ball of the great 
toe. 

Peroneus brevis arifes from the middle of 
the fibula, under a part of the former, and grow- 
ing tendinous, paiTes under the outer ancle, and is 
inferted into the beginning of the upper part of the 
OS metatarfi of the little toe, and fometimes be- 
llows a fmall tendon on the little toe. Its ufe is 
to extend the tarfus, and turn it outward. 

These two laft mufcles riding over the lower 
end of the fibula, are often the caufe of a fprain 
in the outer ancle, when they are vehemently ex- 
erted to fave a fall. 

Extensor pollicis longus arifes from the 
upper and middle part of the fibula and the ligamen- 
tum tranfverfale, and foon becoming a (Irong ten- 
don, is inferted into the laft bone of the great toe. 
This alfo bends the tarfus with a much longer lever 
than it extends the toe. 

Extensor pollicis brevis arifes from the 
fore part of the os calcis, and is inferted into the 
fame place with the former. 

Flexor pollicis longus arifes from the fi- 
bula, oppofite to the extenfor longus, and then 

H 3 pafiing 



m8 of the muscles. 

paffing under the inner ancle, is inferted into the 
under lide of the laft bone of the great toe. This 
extends the tarfus at a longer lever than it bends 
the toe. 

Flexor erevis and adductor pollicis 
are the lame mufcle, aiifing from the two leffer 
offa cuneiformia and os cuboides and calcis. They 
are inferced into the offa fefamoidea, which are tied 
by a ligament to the firfl: bone of the great toe, 
reckoning only two bones to the great toe. Thefe 
mufcles bend the great toe. 

Abductor pollicis arifes pretty largely from 
the inner and back part of the os calcis, and by a 
fmaller beginning from the os naviculare 5 thence 
pafling forward contiguous to the os cuneiforme 
majus, paffes by the external fefamoid bone of the 
^ great toe to its infertion into the firfl bone of the 
great toe. This mufcle is lefs an abdudtor than a 
flexor pollicis pedis 3 it alfo very much helps to con- 
Rthfi the foot lengthways. 

Transversal IS pedis arifes from the lower 
end Of the metatarfal bone of the toe next the leaft, 
and is inferted into the internal fefamoid bone. 
This truly is an addudor of the great toe, and helps 
10 keep the confcridlor of the bottom of the foot. 

Extensor digitorum pedis longus arifes 
;^cute from the upper part of the tibia, and from 
the upper and middle part of the fibula and liga- 
ment between thefe bones ^ then dividing into five 
tciidons^ four of them are inferted into the fecond 

bone 



OF THE MUSCLES. 119 
bone of each leffer toe, and the fifth into the be- 
ginning of the metatarfal bone of the leaft toe, and 
fometimes by a fmall tendon alfo into the little toe. 
This lafl: portion for the mofl: part is feparate from 
its beginning, and may be accounted a diftindt muf- 
cle. The four firft tendons only of this mufcle ex- 
tend the toes, but all five bend the tarfus, and that 
with a longer lever than any of them bend a toe. 

Extensor DiGiTORUM brevis arifes toge- 
ther with the extenfor poUicis brevis from the os 
calcis, and dividing into three fm.all tendons is in- 
ferted into the fecond joint of the three toes next 
the great one. The long extenfors of the toes ferve 
not only to extend them, but alfo contribute to 
the bending of the ancle, which motions are ufually 
performed together in progreflion ; but the (hort 
extenfors ari fin g below the ancle, extend the toes 
only ; and when the long extenfors are employed 
for that adion only, the extenfors of the tarfus 
muft ad at the fame time, to prevent the bending 
of the ancle. This is the reafon wiiy the toes have 
need, though their motions are lefs, of more ex- 
tenfors than the fingers. 

Flexor brevis or perforatus' arifes from 
the under and back part of the 03 calcis, thence 
pafling toward the four leffer tofes, divides into four 
tendons which are inferted into the beginning of 
the fecond bone of each of the leffer toes. Thefe 
tendons are divided to let through the tendons of 
the following mufcles. 

H 4 Flexor 



I20 OF T HE MUSCLES. 

Flexor longus or perforans arifr- frdni 
the back part of the tibia, above the inlcrtioii of 
the pophteus, and part of the fibula ; thence de- 
fcending under the os calcis to the bottom of the 
foot there becomes tendinous, often croffes, and, 
in mod bodies, communicates with the flexor lon- 
gus pollicis pedis ; then it divides into four tendons, 
which pafs through thofe of the flexor brevis and 
are inferted into the third bone of the four lef- 
fer toes. This muide alfo extends the tarfus. The 
fecond beginning of this mufcle arifes from the os 
calcis, and joins the tendons where they divide. 
This portion only bends the toes ; and feeing the 
flexor longus of the toes will, when it ads alone, 
extend the tarfus as well as bend the toes, this por- 
tion, like the Abort extenfors of the toes, feems pur- 
pofely contrived to bend the toes alone. 

LuMBRiCALES arife from the tendons of the 
perforans, and are inferted into the firil bone of 
each of the leffer toes which they bend. 

Abductor minimi digitj pedis arifes by 
the perforatus from the os calcis, and being part of it 
inferted into the metacarpal bone of the leail: toe, 
it receives another beginning from the os cuboides, 
and is inferted into the firll bone of the leaft toe, 
which it bends and pulls outv/ardj and very much 
helps to conftrid the bottom of the foot. 

Abductor secundus minimi digiti arifes 
under the former mufcle from the metatarfal bone, 

and is inferted into the little toe. 

Inter- 



OF THE MUSCLES. 121 

Interossei are feven mufcles which lie like 
thofe of the hands, and arife like them from the 
metatarfal bones, and are inferted like them into the 
laft joints of the four leffer toes, and being in their 
progrefs attached to the tendons which extend the 
fecond joints of the toes, they will extend both thefe 
joints. Thefe mufcles may be fitly divided into ex- 
ternal and internal, the internal alfo bend the firft 
joints, as do all the interoflei in the hand, but here 
the outer ones extend the firft joints ; and if we con- 
fider that the fird of thefe mufcles is analogous to 
the abdudtor indicis of the hand, and that the ab- 
ductor minimi is alike in both, we find that the 
mufcles to move the fingers and leffer toes fideways 
are alike in number, though this motion of the 
toes is in a manner lofl from the ufe of (hoes. The 
mufcles that bend or extend the laft joints of the 
toes will alfo move the fecond and firft, and thofe 
that move the fecond will alfo move the firft, as 
they do in the fingers. 



TAB. XL 



( 122 ) 

TAB. XL 

1 Mufculas frontalis, 

2 Temporaiis. 

3 Orbicularis. 

4 The parotid gland, with its ducS, which pallet 

through the buccinator. 

5 Maftoideus. 

6 Zygoniaticus, 

7 Elevator labii fuperiorls prapriog, 

8 Elevator labiorum communis. 

9 Depreffor labiorum communis, 

I o Sphinder oris. 

I I Depreffor labii inferioris propriiis^ 
12 Buccinator. 

J 3 Sterno-hyoidei. 

14 Coraco-hyoideus, 

15 Maftoideus. 
] 6 Trapezius. 

17 Pedoralis. 

18 Deltoidcs. 



TAB. 



TAB. XI. 



P. 122. 




TAB.xn 




( 1^3 ) 

TAB. XII. 

1 Mufcaliis maftoideus. 

2 Pedloralis. 

3 Biceps flexor cubiti. 

4 Coracobrachialis. 

5 Triceps extenfor cubitL 

6 Latiffimus dorfi. 

7 Serratus major anticus. 

8 Obliquus defcendens abdominis, 

9 Redtus abdominis. 
10 Pyramidalis. 

J I Sartorius. 

12 Fafcialis. 

13 Redus femoris. 



TAB. 



( 124 ) 
TAB. XIIL 

2 Trapezius, 

2 Deltoides. 

3 Infra fpinatus fcapuls, 

4 Teres major. 

5 Rhomboides. 

6 Latiffimus dorfi, 

7 Glutaei. 

8 Obliquus defcendens abdominis. 



TAB. XIV. 



TAB, XIII. 



P./ 24. 




TAB. XIV. 



\ \\\m 



M 



ml 



%, 



-^ 



m. 



/ 




I 



( 1^5) 
TAB. XIV. 



Mufculus deltoides. 

2 Triceps extenfor cubiti. 

3 Anconaeus. 

4 Extenfor carpi radialis primus. 

5 Extenfor carpi radialis fecundus. 

6 Extenfor carpi ulnaris, 

7 Flexor carpi ulnaris. 

8 Deltoides. 

9 Biceps flexor cubiti. 

10 Brachiasus internus, 

1 1 Triceps extenfor cubiti. 

12 Supinator radii longus. 

1 3 Extenfores carpi radiales. 

14 Extenfor communis digitorum. 

1 5 Extenfor carpi ulnaris. 

16 Flexor carpi ulnaris. 

17 Anconaeus. 

18 Extenfor pollicis primus. 

19 Extenfor pollicis fecundus. 



TAB. XV. 



( ^26 ) 

TAB. XV. 

1 Mufculus deltoides. 

2 Pedoralis. 

3 Biceps flexor cubiti. 

4 Triceps extenfor cubiti. 

5 The fafcia tendinofa of the biceps mufcle, 

6 Supinator radii longus. 

7 Flexor carpi radialis. 

8 Gluteus. 

9 Vaftus externuSo 

10 Biceps femoris- 

1 1 Semitendinofbs. 

12 Semimembranofus, 

13 Gafirocnemiiis, 

14 Soia?us, 



I 



TAB. 



Tu^BXV 




P./2d. 



( 127 ) 

TAB. XVI. 

1 Mufculus redtus femoris. 

2 Vaftus externus. 

3 Vaftus internus. 

4 Sartorius. 

5 Pediinseus. 

6 The large head of the triceps. 

7 Gaflrocnemius, 

8 Soteus. 

9 Membranofus. 

10 Redlus femoris. 

1 1 Vaftus internus. 

12 Vaftus externus. 

13 Sartorius. 

14 Pedinsus. 

15 Gaftrocnemius. 

16 Solseus. 

17 Tibialis anticus. 

1 8 Extenfores digitorum. 



TAB. 



{ 128 ) 

TAB. XVII. 

1 Mufculus abdudlor poUicis. 

2 Addudor poUicis. 

3 Flexor brevis. 

4 Quadratus feu palmaris brevis. 

5 The firong ligament of the carpus that 

binds down the tendons of the flexors of 
the fingei'S*^ 

6 Abdudlor minimi digiti. 

7 A probe under the tendons of the perforatus. 

8 A probe under the tendons of the perforans. 

9 Lumbricales. 
ID Perforatus. 

1 I Flexor carpi radialis. 
12 Flexor carpi ulnaris. 



TAB. XVIIL 



TAB. XVII. 



P./28. 




TAB. XVIII. 



■P.ftO. 




( 129 ) 

TAB. XVIII. 

2 Tendo achilles. 

2 That part of the aftragalus which articulates 

with the tibia. 

3 The tendon of the tibialis anticiis. 

4 The tendon of the extenfor poUicis pedis 

longus. 

5 The tendons of the extenfor digitorum com- 

munis. 

6 Extenfor pollicis pedis brevis. 

7 Extenfor digitorum brevis. 

8 The union of the tendons of the extenfor 

longus and the extenfor brevis. 



TAB. XIX. 



'( ^30 ) 

- TAB. XIX. 

J Mufculus triceps extenfor cubiti. 

2 DeltoideSo 

3 Teres major. 

4 Latiiiimus dorfi. 

5 Pedoralis. 

6 Obliquus defcendens abdominis. 

7 Red:os abdominis, 

8 Sartorias. 

9 Redtus femoris. 

10 Vaftiis externus^ 

1 1 Vaftus internus. 

12 Gaftrocoemius, 

13 Sofaos. 

14 Tibialis anticos. 



TAB. XX, 



n^B.XIX 




T_AB.XX. 



I"./ 3/. 




( ^31 ) 

TAB. XX. 

This table is done after the famous ftatue of 
Hercules and Antseas. The mufcles here exhibit- 
ed being all explained In the other plates, the fi- 
gures are omitted to preferve the beauty of the 
plate. 



I2 THE 



•"6^ 



( J33 ) 



THE 



ANATOM Y 



OF THE 



Human Body^ 



BOOK IIL 

CHAPTER I. 

Of the external parts ^ and common integuments. 

TH E vulgar names of the external parts of 
the human body being fufficiently known 
for the defcription of any difeafe or ope- 
ration ^ I (hall only deicribe thofe which anatomifts 
have given for the better underflanding of the fub- 
contained parts. 

The hollow on the middle of the thorax, un- 
der the breafts, is called fcrobiculus cordis : the 
middle of the abdomen for about three fingers 
breadth above and below the navel, is called regio 

1 3 umbi- 



134 EXTERNAL PARTS, &c.. 
umbilicalis y the middle part above this, epiga- 
ftrium 5 on each fide of the epigaflrium, under the 
cartilages of the lower ribs, hypochondrium ; and 
from below the regio- umbilicalis, down to the 
offa ilia and offa pubis, hypogallrium. 

CuTicuLA or SCARF SKIN IS that thin infen- 
fible membrane which is raifed by bliflers in living 
bodies. It is extended over every part of the true 
fldn, unlefs where the nails are. It appears to me 
in a microfcope a very fine fmooth membrane, on- 
ly unequal where the reticulum mucofum adheres 
to it. Lewenhoeck, and others, fay it appears 
fcaly, and compute that a grain of fand of the 
hundredth part of an inch diameter, will cover 
two hundred and fifty of thefe fcales^ and that 
each fcale has about five hundred pores ; fo that a 
grain of fand will cover 125000 pores thro' which 
we perfpire. Its ufe is to defend the true Ikia 
that it may not be expofed to pain from whatever 
it touches -, and alfo to preferve it from wearing : 
it is thickeft on thofe parts of the bottom of the, 
foot which fuftain the body, and in hands much 
iifed to labour, being fo contrived as to grow the 
thicker the more thofe parts are ufed. In fcorbu- 
tic diforders the cuticula will fometimes become 
fcurfy and full of little ulcers, which are apt to 
remain even when the caufe.is taken away, but the 
cuticle being taken off by a blifter, the new cuti^ 
clp wiii be found %, and though the cutis, is afteded 

and 



EXTERNAL PARTS, &c. 135 
^nd full of little tumours, the, difcharge of the bii- 
Her will often cure them alfo. 

Between this and the true fkin is a fmall 
quantity of flimy matter, which v/as fuppofed by 
Malpighi and others, to be contained in proper 
veffels, interwoven with one another, and there- 
fore by them named reticulum mucoliim. It is 
moft confiderable where ■ the cuticula is thickeft, 
and is black, white, or dufky, fuch as is the com- 
plexion ; the colour of this and the cuticula being 
the only diiference between Europeans and Afri- 
cans or Indians, the fibres of the true fkin being 
white in all men 3 but the florid colour of the 
cheeks is owing to the blood in the minute vef- 
fels of the ikin, as that in the lips to the veffels in 
the mufcular fiefh ; for the cuticula being made of 
excrementitious matter, has no blood veffek 

Cutis, or true skIxV, is a very compafl, 
ftrong, and feniible membrane, extended over all 
the other parts of the body, having nerves termi- 
nating fo plentifully in all its fuperficies, for ths 
fenfe of touching, that the fineft pointed infiru- 
ment can prick no where without touching fome 
of them. Thefe nerves are faid by Malpighi 
and others, who have examined them cai-efully, to 
terminate in fmall pyramidal papills 5 neverthelefs 
it feems that a plain fuperficies of the fkin is much 
fitter and more agreeable to what we experience of 
this fenfation ; for a plain fuperficies expofing all 
the nerves alike, I think, would give a more equal 

I 4 fenfation. 



136 EXTERNAL PARTS, &c, 

fenfation, while nerves ending in a pyramidal pa« 
pilla would be exceeding fenfible at the vertex of 
tliat papilla^ and thofe at the fides and round the 
bafe, which would be far the greateft part, would 
be the leaft ufeful. Immediately under the {kin 
upon the fhin bone, I have twice feen little tumors, 
lels than a pea, round and exceeding hard, and fo 
painful that both cafes were judged to be cancerous; 
they were cured by extirpating the tumor; but 
what was more extraordinary, was a tumor of this 
kind, under the fkin of the buttock, fmall as a 
pin's head, yet fo painful that the leaft touch 
was infupportable, and the fkin for half an inch 
round was emaciated; this too I extirpated, with 
fo much of the fkin as was emaciated, and 
fome fat. The patient, who before the operation 
could not endure to fet his leg to the ground, nor 
turn in his bed without exquifite pain, grew im- 
mediately eafy, walked to his bed v/ithout any 
complaint, and was foon curedi 

Glandule miliares are fmall bodies like 
millet feeds, feated immediately under the fkin in 
the axillas ; and are faid to have been found under 
all other parts of the ikin, where they have been 
looked for with microfcopes. Thefe glands are 
fuppofed tofeparate fv/eat ; which fluid was thought 
to be only the materia perfpirabilis flowing in a 
greater quantity, and condenfed, 'till Sanctorius 
afTured us that it is not fo, and that more of the 
materia perfpirabilis is feparated in equal times than 

cf 



EXTERNAL PARTS, &c. 137 
of fweat ; of the former, he fays, ufually fifty two 
ounces a day in Italy, where his experiments were 
made, and of the latter not near fo much in the 
mod profufe fweats ; which feems to favour the 
opinion of the exigence of thefe glands : but 
whoever reads Mr. Hales's experiments will 
find, that what Sanctorius accounted for 
, by an imaginary infehfible perfpiration, different 
from that which in the greateft degree produces 
fweat, is really made by the lungs in refpiration^ 
and is ten times more than all the ordinary per-, 
fpiration through the cutis, and feems to be but 
the fame kind of fluid difcharged both ways ; for 
whenever it is interrupted through the fkin in 
cold weather, then the lungs are overcharged, 
which occafions coughing to get rid of it, which 
in a greater degree is an afthma. Hence too it is 
that thofe who perfpire molt in the fummer, are 
moft fubjedl to aflhmatic diforders in the winter; 
and moft of all fo, when the air they breathe is ful- 
left of vapour, and therefore leaft capable of con- 
veying this matter from the lungs. That this kind 
of perfpiration is very great, is fufBciently fhewn 
by breathing upon glafs, or any thing that is fmooth 
and cold. 

Membrana ADIP03A IS all that membrane 
immediately under the fkin, v/hich contains the 
fat in cells ; it is thickefl on the abdomen and but- 
tocks, and thinneft neareft the extremities; and 
where the mufcles adhere to the fkin, and on the 

penis. 



138 EXTERNAL PARTS, fee- 
penis, little or none : it contributes to keep the in- 
ner parts warm, and by filling the interfiices of 
the mufcles, renders the furface of the body fmooth 
and beautiful, and may ferve to lubricate their fur- 
faces. Whether the decreafe of fat, which often 
follows labour or ficknefs, proceeds from its being 
reaffumed into the blood veffels, or whether it is 
conftantly perfpiring through the ikin, and the 
ieffening of its quantity is from the want of a fup- 
ply equal to its confumption, is with me a matter 
of doubt, though the former opinion, J know, ge- 
nerally prevails. The cells of this membrane com- 
municate throughout the whole body fo much, 
that from any one part, the whole may be filleci 
with air. I have (ten two cafes where the wind- 
pipe being cut, and the external wounds being 
clofely fdtched by injudicious furgeons, the air 
that efcaped at the wound of the wind-pipe get- 
ting into the ceils of the membrana adipofa, blew 
up the upper part of the body like a bladder. 
The like accident I have feen from a broken 
rib, where, I fuppofe, the end of the rib had 
pricked the lungs j all thefe perfons died. In thefe 
cells the water is contained in an anafarca, which 
from its weight, firft fills the depending parts^ 
as the air in the former cafes did the upper parts 5 
and when thefe cells are very full, the water fre- 
quently palTes from them into the abdomen, and 
after tapping, though the limbs were ever fo full, 
they will almoft empty themfelves in one night's. 
I time. 



EXTERNAL PARTS, &c. 13-^ 
time. This membrane is the ufual feat of im- 
podumations and boyls, in both which nature, 
uninterrupted, always corrodes a hok in thQ ikin^ 
from whence we may learn that the beft way 
of opening any impoftumation is by . a hole, and 
that too as near the time of its breaking natu- 
rally as may be, that nature may make the ut- 
moft advantage of the difcharge. There is fome- 
times a large kind of boyl or carbuncle in this 
membrane, which firfc makes a large ilough and a 
number of fmall holes through the fkin which irs 
time mortifies and cafts oft, but the longer the Hough 
is fufFered to remain, the more it difcharges, and the 
more advantage to the patient ; at the latter end of 
v/hich cafe the matter has a bloody tindure, and 
a bilious fmell, exadly like what comes from ulcers 
in the liver ; and both thefe cafes are attended with 
fweet urine as in a diabetes. 

MAiMMiE, the BREASTS, fcem to be of the 
fame ftrudlure in both fexes, but largeft in women. 
Each breafl: is a conglomerate gland to feparate r^ilk, 
with its excretory duds -, which are capable of very 
great diftention, tending toward the nipple, which 
as they approach, they unite, and make but a few ■ 
duds at their exit. There are to be met with m 
authors inftances atteiled of men giving fuck, when 
they have been excited by a vehement aefire of 
doing it : and it is a common obfervation, that 
milk will flow out of the breads of new born chil- 
dren, both male and female. 

The 



I40 EXTERNAL PARTS, &c. 

The breafts and uterus in women, the tongue, 
mouth, and penis in men, and the eyes in chil- 
dren, are the parts moft fubjedl to cancers j yet 
there is no part where this difeafe has not fome- 
times fixed. It is a matter of difputfe among fome 
furgeons, whether cancerous tumors (hould ever be 
extirpated or not, though it is certain none of thefe 
ever were cured without, and being extirpated, 
there have been many. The objection againfl: extir- 
pation is this, that the operation often provokes the 
part which otherwife might lye quiet : but I do 
not think this is true -, m defperate cafes, where 
we cannot extirpate, we find the beft remedy is 
plentiful bleeding (which alfo is nature's laft refort) 
gende conftant evacuations by ftool, and a vegeta- 
ble diet > and though phyfic never cures while the 
tumor remains, yet after extirpation it is highly 
ufeful, and even the worfc conftituticns have fome- 
times been brought to their primitive ftate. An 
eminent furgeon in the city having a patient with 
a cancerated breaft, extremely large, and fo much 
ulcerated that the flench of it was infupportable 5 
fhe infifted upon the extirpation againft all advice, 
with no other hopes but to be delivered from the 
ofFenfive fmell. Some time after the operation the 
wound looking extrem^ely fordid, he fprinkled it 
all over with red mercury precipitate, which put 
the patient into a high falivation, upon which the 
breaft grew clean and healed, the patient recover- 
ed^ and, contrary to all expedation, lived many 

years 



MEMBRANES IN GENERAL. 141 
years in good health. From this accident I learnt 
the ufefuhiefs of falivating after extirpating cancer- 
ous tumors, though nothing is more hurtful be- 
fore. In the extirpation of a breaft and all other 
tumors, as much ficin as is pofiible iliould be fav- 
ed, for the lofs of a great deal of Ikin is fufficient 
to make an incurable ulcer in the moft healthful 
body, and much more fo in a bad conilitution. 



CHAPTER II. 

Of the membranes in general, 

EVERY diftinfi: part of the body is covered, 
and every cavity is lined with a (ingle mem- 
brane, v^hofe thicknefs and flrength is as the bulk 
of the part it belongs to, and as the friftion to 
which it is naturally expofed. 

Those membranes that contain diiiinft parts, 
keep the parts they contain together, and render 
their furfaces fmooth, and lefs fubje6l to be lace- 
rated by the adions of the body 3 and thofe which 
line cavities ferve to render the cavities fm.ooth and 
fit for the parts they contain to move again ft. 

The membranes of all the cavities that contain 
folid parts, are ftudded with glands, or are provided 
with veffels, v/hich feparate a miucus to make 
the parts contained move glibly againft one another, 
and not grow together ; and thofe cavities which 
are expofed to the air, as the nofe, ears^ mouth, 

and 



142 SALIVARY GLANDS. 

and trachea aiteria, have their membranes befet 
with glands which feparate matter to defend them 
from the outer air. Thofe membranes that have 
proper names, and deferve a particular defcription, 
will be treated of in their proper places. 



CHAPTER III. 

Of the Jalivary glands^ 

PAROTISj OrMAXILLARIS SUPERIOR, IS thc 
largefc of the falivary glands ^ it is fituate be- 
liind the lower jaw, under the ear ^ its excretory 
dufl; pailes over the upper part of the maffeter muf- 
cle, and enters the mouth through the buccinator. 
This gland has its faliva promoted by the motions 
of the lovvxr jaw. Its dud: paffes over the tendi- 
BOiis part of the maffeter mufcle, that it may not 
be compreffed by that mufcle, which would ob- 
ilrud the faliva in it, though it is frequently faid 
that it panes over that mufcle that it may be com- 
preffed by it, to promote the faliva. In {heep, 
liorfes, &c. whofe jaws are long, this mufcle is in- 
ferted far from the center of motion, that the end 
of the jaw may be moved with fufficient flrength, 
and that diilant infcrtion requiring a greater length 
of mufcle, that its m.otion may be quick enough, 
no part of this mufcle could be allowed to be ten- 
dinous 5 therefore^ it feems, to avoid the inconve- 
nience 



SALIVARY GLANDS. 143 
-nience of compreffion from the mnfcle, the duct in 
thofe animals goes quite round the lower end of it. 
When this dud: is divided by an external wound, 
the faliva v/ill flow out on the cheek, unlefs a con- 
venient perforation be made into the mouth, and 
then the external v/ound may be healed. I have 
feen patients with this gland ulcerated, from which 
there was a conftant efFuiion of faliva, 'till the 
greateil part of the gland was confumed with red 
mercury precipitate; and then they healed with 
little trouble. Hi l d a n u s m.entions the fame cafe, 
which for two years had been under the care of a 
furgeon without fuccefs 3 and Vv^as at lafl: cured by 
the application of an adual cautery. 

Maxillaris inferior is fituate between 
the lower jaw and the tendon of the digaftric muf- 
cle. Its du6t paffes under the mufculus mylohyoi- 
deus, and enters the mouth under the tongue, 
near the dentes inciforii. I was at the opening of 
a woman who was fuffocated by a tumor which 
begun in this gland, and extended itfelf from the 
fternum to the parotid gland on one fide in fix 
weeks time, and in nine weeks killed her^ it was 
a true fchirrus, and weighed twenty fix ounces. In 
a man which I dififeded, I found a quantity of pus 
near this gland, and a bundle of m.atter not unlike 
hair as large as an hen's egg. 

Sublingualis is a fmall gland fituated under 
the tongue, between the jaw and the ceratoglofliis 
mufcle. In a calf I found feveral dudts of this 

gland 



144 SALIVARY GLANDS, 

gland filled by an injedion into the dudl of the 
fubmaxillary gland ; but Morgagni and others 
fhew, that the duds of this gland enter the mouth 
diredly from the gland in feveral places near the 
grinding teeth. 

ToNsiLiiA is a globular gland about the bignefs 
of a haz:el nut, fituate upon the pterygoideus inter- 
nus mufcle, between the root of the tono;ue and 
the uvula. It has no dud continued from it, but 
empties all its fmall duds into a finus of its own, 
which finus, when the gland is inflamed, may ea- 
fily be miftaken for an ulcer. This gland with its 
fellow, dired the mafticated aliment into the pha- 
rynx, and alfo ierve for the uvula to fhut down 
upon wheB we breathe through the nofe. They 
are compreffed by the tongue and the aliment, when 
the former raifes the latter over its root, and there- 
by opportunely emit their faliva to lubricate the 
food for its eafier defcent through the pharynx. A 
fehirrous tumor of either of thefe glands is a com- 
mo0 difeafe, and it admits of no remedy but ex-^ 
tirpation. The beft way of extirpating them, is, 
I think, by ligature : if the gland is fmall at its 
bafis^ the ligature may be tied round it, which I 
have often performed by fixing the ligature to the 
end of a probe bent, and fo drew it round the 
gland, and tied it ; and in a few days the glands 
dropped ofFj but meeting with other cafes of this 
kind, where the bafis of the gland was too large to 
tie, I contrited an inftrument like a crooked needle 

•"" " few. 



SALIVARY GLANDS. 145 

let in a handle, with an eye near the point; I 
thruft this inftrument, with a ligature into it through 
the bottom of the gland, and then taking hold of 
the Ugature with a hook, I drew back the inftru- 
ment ; then drawing the double ligature forwards, 
I divided it, and tied one part above and the other 
below, in the fame manner that I did to extirpate 
part of the omentum in the cure of an hernia, and 
this fucceeded as well as the former : See the plate 
at the latter end of this book. 

Pressure upon the farface of a gland very 
much promoting the fecretion that is made in if, 
thefe glands are fo feated as to be preffed by the 
lower jaw, and its mufcles, which will be chiefly 
at the time when their fluid is wanted ; and the 
force with which the jaw muft be moved, being 
as the drinefs and hardnefs of the food maflicated, 
the fecretion from the glands depending very much 
upon that force ; it will alfo be in proportion to the 
drinefs and hardnefs of that food which is necefiliry ; 
for all food, being to be reduced to a pulp, by be- 
ing broke and mixed with faliva before it can be 
fwallowed fit for digeftion, the drier and hai-der 
foods needing more of this matter, will from this 
mechanifm be fuppiied with more than moifter foods 
in about that proportion in which they are drier 
and harder j and the drier foods needing more fa- 
liva than moifter, is the reafon why we can eat 
lefs and digefl lefs of thefe than thofe. What 
quantity of faliva thefe glands can feparate from 

^ K the 



146 SALIVAP.Y GLANDS. 

the blood, in a given time, will be hard to deter- 
mine, but in eating of dry bread it cannot be lefs 
than the weight of the breads and many men, 
in a little time, can eat more dry bread than twice 
the fize of all thefe glands 5 and fome, that are not 
ufed to fmoaking, can fpit half a pint in the fmoaking 
one pipe of tobacco 3 and fome men in a falivation, 
have fpit, for days or weeks together, a gallon in 
four and twenty hours; and yet, I believe, all thefe 
glands put together, do not weigh more than four 
ounces. 

The membrane which lines the mouth and pa- 
late, and covers the tongue, is every where befet 
with fmall glands, to afford fall va in all parts of 
the mouth to keep it moin -, for thofe more remote 
are chiefly concerned in time of maftication. Thefe 
fmall ghrids have names given them according to 
their refpefiive fituations, as buccales, labiales, lin- 
guales, fliuciales, palatini, gingi varum, and uvu- 
lares. 

A GLAND is cbiefiy compofed of a convolu- 
tion of one or more arteries of a confiderable length, 
from v/hofe fides arife vaft numbers of excretory 
dudts, as the ladleals arife from the guts, to receive 
in each gland their proper juices, as the ladleals do 
the chyle 5 and though the larger fecretibns are m.ade 
by vifible glands, yet u neon vol ved arteries may alfo 
have excretory dufts for the fame purpofe. And 
this way, I imagine, fecreticns are made from all 
the membranes that line cavities, and fome others. 

There 



SALIVARY GLANDS. 147 

There alfo arife from thefe arteries lymphatic vef- 
fels, whofe ufe feems to be to take off the thinned 
part of the blood, where a thick fluid is to be fe- 
creted, feeing they are found in greateft plenty in 
fach glands as feparate the thickefl fluids, a^s in 
the tefticles and liver 3 and it is obfervable that 
where the thickefl fecretions are made, the velocity 
of the blood is the lead, as if it w^as contrived to 
give thofe feemingly more tenacious parts more 
time to feparate from the blood. The arteries that 
compofe different glands are convolved in different 
manners ; but whether or no their different fecretions 
depend at all upon that, I doubt, will be difficult 
to difcover. The excretory dudts arife from the 
arteries, and unite in their progrefs as the roots of 
trees do from the earth, and as different trees, plants, 
fruits, and even different minerals, in their grow- 
ing, often derive their diflinft, proper, nutricious 
juices from the fame kind of earth y fo the excre- 
tory dudls in different glands, feparate fiom the 
fame mafs of blood their different juices : 'But what 
thefe different fecretions depend upon, whether the 
ftrudlure of the parts, or different attradions, or: 
what elfe, we have no certainty about, though 
this fubjed: has employed feveral ingenious UTiters. 
For my own part, from the great fimplicity and 
uniformity ufually feen in natui-e's works,-! am 
moft inclined to think different fecretiot^s arife from 
different attradions, feeing that in plants and rnine- 
rals there feem.s to be no other way. 

K2 CHAPTER 



148 PERITONEUM, 

CHAPTER IV. 

Of the peritoneum^ omentum^ duBus alimentalh^ 
and mefentery, 

PERITONEUM is a membrane which 
lines the whole cavity of the abdomen. It 
contains the liver, fpleen, omentum, ftomach, guts, 
and mefentery, with all their veffels and glands ; 
the upper part of it is no other than the proper 
membrane of the diaphragm, for there is no more 
rcafon to call that, part of the peritoneum, than 
there is for calling the membrane on the other fide 
of the diaphragm part of the pleura or mediadi- 
num. The fore part next the mufcles of the ab- 
domen, and their tendons may be divided into two 
lamins, yet, I think, anatomifts in defcribing the 
duplicature or lamins of the peritoneum have not 
always meant this divifion, but have taken the ten- 
dons of the tranfverfe mufcles for the outer lamina, 
and coniidered the other as one membrane, feeing 
that it is between thefe tendons and the peritoneum 
that the water is found in that kind of dropfy which 
is called the dropfy in the duplicature of the peri- 
toneum. Upon the loins the inner furface only is 
fmooth, and the outer part a fort ©f loofe mem- 
brana adipofa, in which are contained the aorta, 
vena cava, vafa fpermatica, and pancreas, v/ith 
other parts of lefs note. The middle of the peri- 
toneum upon the loins is joined to the mefentery 

3 i^ 



OMENTUM, &c. 149 

in fuch a manner, as makes fome account it a pro- 
-ducSion of the peritoneum, and fome part Of the 
external membrane of the duodenum, becoming 
one membrane with the inner or fmooth lamina of 
the peritoneum, and part of the redlum is covered 
in the fame mann6r ^ but the kidneys and bladder 
,of urine are contained in a diftind duplicature of 
this membrane. The dropfy of the peritoneum 
inay ,be diftinguifhed by being leaft prominent 
about the navel, for there the tendons and the peri- 
toneum w^ill not feparate; and the water, in thofe 
Ihat I have differed, had made the parts where it was 
contained as foul as any ulcer ; therefore none of 

them, I prefume, could have been ciired by opera- 

A.'^n ji\s*\4 siiOi. jii A 
tion. ....^.. _4. c ■ 

For the umbilical veflels, fee chap. Of the foe- 
tus. For the procefTus vaginalis, chap. Of the parts 
of generation in men. 

Omentum, or cawl, is a fine membrane 
larded with fat, fomewhat like net- work : It is 
fituated on the furface of the fmall guts, and 
refembles an apron tucked up ; its outer or upper 
part, named ala fuperior, is conneded to the bot- 
tom of the ftomach, the fpleen, and part of the 
inteflinum duodenum; and thence defcending a 
little lower than the navel, is refledted and tyed to 
the inteflinum colon, the fpleen, and part of the duo- 
denum i this laft part is called ala inferior ; and the 
fpace betv/een the alse is named burfa. This cavi- 
ty is very diftind; in mod brutes, but feldom fo in 

K 3 men. 



150 PERITONEUM, 

men. Sometimes both alas are tyed to the liver, 

and, in difeafed bodies, to the peritoneum. Its ufe 

is, to lubricate the guts, that they may the better per-^ 

form their perifialtick motion. Malpighi defcribes 

adipofe dudls in this membrane to carry the fat from 

the cells into the vena ports, and thinks it a necef- 

fary ingredient in the bile. In dropiies of the ab- 

dom.en, and in perfons who from any other caufe 

have died tabid, it is generally rotten and decayed ^ 

and fometimes the guts in thefe cafes adhere to one 

, another : But v^hether thefe adhefions proceed from 

?the omentum's ceafing to perforiii its office, or from 

^Ithe periilahick motion of the guts being long dif- 

continued thrGUgh abilinence, or both, I cannot de^ 

- ferminep^si I^esfi singrt, 

-^ DucTfi^^iiiMi^NTmLis, is the c^lbphagus, 
'^omach, and iguts, viz, duodenum, jejunum, ile- 
him J colonel c^uiB or apendicula vermifbrmis, and 
"^redum. '^ o:-n: B5i£o,:^narr . - 

OESOPHAGUS or gullet, is the beginning of the 
rfialimentary dudti its upper part is wide and open, 
^ -f^ behind the tongue to receive the maflicated 
sliiment ; :'it begins from the baCs of the fcull near 
the proceffds pterygoides of the fphenoidal bone, 
then defcending becomes round, and is called vagi- 
nalis guls ; it runs from the tongue clofe to the 
fpine, under the left fubclavian blood vefiels, into 
and through the thorax on the left fide, then piercing 
the diaphragm, it immediately enters the ftomach. 
It is compofed of a thin outer coat, which is no 

more 



V OMENTUM, &c. ■ i^r 

more than a proper membr ane to the middle or 
■mufcular coat. The middle coat is compofed of 
longitudinal and circular mufcular fibres, but chief- 
ly circular, abundantly thicker than the fame coat in 
the guts 5 becaufe this has no foreign power to af- 
fift it, as the guts have, and becaufe it is neceifary 
the food fliould m.ake a fliorter ftay here than there. 
The inner coat is a pretty fmooth membrane, befet 
with many glands, which fecrete a mucilaginous 
matter, to defend this membrane, and render the 
defcent of the aliment eafy. 

Ventriculus, the ftomach, is fituated under 
the left fide of the diaphragm, its left fide touch- 
ing the fpleen, and its right is covered by the thin 
edge of the liver -, its figure nearly refembles the 
pouch of a bag-pipe, its left end being moft capa- 
cious, the upper fide concave, and the lower convex; 
it has two orifices, both on its upper part : the left, 
through which the aliment pafi^es into the ftomach, 
is named cardia; and the right, through which it 
is conveyed out of the ftomach into the duodenum, 
is named pylorus ; where there is a circular valve 
which hinders a return of aliment out of the gut, 
but does not at all times hind^:ihp pU jfrom flow- 
ing into the ftomach. .=- " .if .- 

The coats of the ftomach are three; the ex- 
ternal membranous, the middle mufcular, whofe 
fibres are chiefly longitudinal and circular, the in- 
ner membranous, and befet with glands, which 
feparate a mucus. This laft coat is again divided 

K4 by 



X52 PERITONEUM, 

by anatomifls into a fourth, which they call villpfa. 
As themufcular coat of the ftomach contrads, the 
inner coat falls into folds, v/hich increafe as the 
flomach lelTens, and confequently retard the aliment 
nioft when the ftomach is neareft being empty. 

The manner in which digeftipn is performed 
has been matter of great controverfy. The ancient^ 
generally fuppofed the food concotled by a fermen- 
tation in tliC ftomach : Bat the mioderns more ge- 
nerally attribute it to the m.ufcular force of the fto- 
mach 5 which Dr. Pitcairne has computed to 
be equal to a hundred and feventeen thoufand an4 
eighty eight pound weight, to which being added 
the abfolute force of the diaphragm and abdominal 
mufcles (but for what reafon I am at a lofs to con- 
ceive, when fo fmall a part pf that force can be ex- 
erted this way) the fum then will be more than 
twice as much ; a force indeed equal to the end for 
which he affigns it. Nov/ this force of the mufcu- 
lar coat of the ftomach is near forty tipes greater 
than what Borelli has aftigned to the heart, 
which is much ftronger ; and Dr. Keil has under- 
took to prove, that the force which the heart ex- 
erts is not thrice as many ounces as Borelli com- 
putes it to be thoufand pounds weight. Yet this 
s as certain as that adion and readlion are the fame ; 
that the abdominal mjjfcles and the diaphragm 
com.prefs the ftomach with no greater force than 
they do the liver and all other parts contained in the 
abdomen 5 and that the fcetus in utero, and all the 

vifcera 



DUCTUS ALIMENTALIS. 153 

yifcera in the abdomen, receive much more of this 
force, during the time of geftation ; and yet nei 1 
ther the foetus, nor any other contained part, is di- 
gefted by that force -, and for the force with which 
the ftomach itfelf ads, it will be jufl: the fame with 
the readion of the food upon it, and therefore 
fliould be as much more liable to be digefted by 
this and the other force than the food, as it oftner 
feels thefe forces than that (only that living bodies 
are not fo liable to digeftion as dead ones :) Befides, 
it may be demonftrated, that the force with which 
the ftomach compreffes any part of its contents, is 
not greater than what is given to equal parts of the 
contents in the fmall guts; for if the moment of a 
mufcle is as its weight, and if the mufcular coat of 
the ftomach does not bear a greater proportion to 
the mufcular coat of a fmall gut, than their diame- 
ters bear ; a fedlion of the ftomach having fo many 
more equal parts to prefs than a like fedion of a 
gut, it will require juft fo much more force to give 
each part the fame preflure. Dr. Drake has fup- 
pofed, that digeftion is performed in the ftomach, 
as in Papin's Digefter, in which hypothefis are 
contained all the abfurdities of that of Pitc airne, 
with this addition, that the ftomach muft be as ir- 
refiftible to diftention at that time, as his iron pot, 
and the orifices as forcibly fecured 5 but then in- 
deed it ftiews how bits of bones, which dogs fwal- 
low, may be retained in the ftomach without tear- 
ing it > which difBculty, in my opinion, Dr. Pit- 

cairne 



154 DUCTUS ALIMENTALIS. 

CAiRNE has not fufficiently accounted for, though 
it is none of the leaft in his hypothefis. In gra- 
nivorous birds, where digeftion is made by mufcu- 
lar force, their fecond flomach is plainly contrived 
for comminuting or digefting their food that way; 
for befides that it is one of the ftrongeft mufcles in 
their bodies, its infide is defended with a hard and 
ilrong membrane that it may not be torn ; and 
tbefe birds always eat with their grain the roughed and 
harded little ftones they can find, which are necef- 
fary for grinding their food, notwithflanding it is 
firft foaked in another ftomach, and is alfo food of 
very eafy digefiion. In ferpents, fome birds, and fe- 
veral kinds of iiili, which fwallovt? whole animals, 
and retain them long in their ftomachs^ digefiion 
feems to be performed by a menflraum ; for we 
frequently find in their llomachs animals fo totally 
digefled, before their form is deflroyed, that their 
very bones are made foft. In horfes and oxen, di- 
gefiion is but little more than extradting a tindture ^ 
for in their excrements, when voided, we fee the 
texture of their food is not totally deflroyed, though 
grafs, in particular, feems to be as eaiily divided 
as any food v^/hatever, and the corn they eat is often 
voided entire y and in the excrements of men, 
are often feen the ikins> of fruits undigefted, and 
fmali fruits, iiich as curranis, unbroke, and worms 
alfo continue unhurt, both in the ftomach and guts. 
Therefore, by comparing oar ftomachs vv^ith thofe 
bere mentioned^ it appears to me that our digeftioB 



DUCTUS ALIMENTALIS. 155 

is performed by a menftrum, which is chiefly fali- 
va, gently affifted by the adion of the ftomach, 
and the abdominal mufcles, and by that principle 
of corruption which is in all dead bodies. For di- 
geftion is no other than corruption or putrefadion 
of our food ; therefore meats preferved from cor- 
ruption by fait or fpirits are hard of digeftion and 
unwholfome. Neverthelefs when this digefting 
menflruum of the ftomach is too crude, the fame 
falts or fpirits, moderately ufed, become a remedy; 
and though meat long faked is fo very unwhole- 
fome, it feems not to be from the fait itfelf, but 
the meat made undigeflible by being long falted ; 
for thofe who eat the greateft quantity of fait at 
their meals are not fubjedted thereby to the fame 
diflempers. And this digefting menftruum, when 
the flomach is empty, exciting that uneafinefs which 
we call hunger, our appetites and our digeftion are 
thereby neceffarily fuited both as to time and quan- 
tity. 

Duodenum is the firft of the three fmall guts; 
it begins from the pylorus of the ftomach, and is 
thence refledled downward ; it firft pafl!es by the 
gall-badder, and then under the follov/ing gut and 
mefentery, and coming in fight again in the left 
hypochondrium, it there commences jejunum, 
which is the fecond of the fmall guts 3 but the 
place where this ends and the other begins is not 
precifely determined. 

Jejunum 



156 DUCTUS ALIMENTALIS. 

Jejunum is fo called from its being founds 
for the mod part, empty ; it is fituated in the re- 
gio umbilicalis, and makes fomewhat more than a 
third part of the fmall guts. It is djftinguifhed from 
the following got by its coats, which are a fmall 
matter thinner, and lefs pale. 

Ileum is the continuation of the former^ fitu- 
ated in the hypogaftrium, and very often fome part 
of it in the pelvis of the abdomen, upon the bladr 
der of urine, efpecially in women 5 it enters the 
colon on the right fidej, near the upper edge of the 
OS ilium. This great length of the fmall guts is 
evidently for the convenience of a greater number 
of ladteais, that the chyle which miifes their ori- 
fices in one place may not efcape them in another i 
but thofe animals which fwallow their food whole^ 
and have it a long time in their flomach and guts^ 
have fhorter guts and fewer ladleals. 

Colon is the Srlt of the great guts ; it begins at 
the upper edge of the right os ilium ; thence afcend- 
ing paffes under fome part of the iiver, and the bot- 
tom of the ftomach, from the right hypochondrium 
to the left, and thence defcends to the pelvis of the 
abdomen, 

C-S:CUM, or APPENDICULA VERMIFORMIS5 

is fituated on the beginning of the colon 5 it is lefs 
than an earth-worm, with a fmall orifice open- 
ing into the colon : This gut has feldom any thing 
in it. In men it is called one of the large guts, 
though it is the fmalied by far 5 but the miflake 

arifes 



DUCTUS ALIMENTALIS. 157 
arifes from copying the antients, whofe defcriptions 
of all the parts contained in the abdomen, feem to 
betaken from dogs, for in them, and in many other 
animals, it is very large : And fome fifli have them 
in great numbers, but very fmall ; I have counted 
in a mackrell above one hundred and fifty. 

Rectum is the continuation of the colon thro' 
the pelvis to the anus. The lower end of this gut 
is the feat of the true fiftula in ano, v/hich ufually 
runs betwixt the mufcular coat and the inner 
coat ; it is cured by opening it the whole length in- 
to the cavity of the gut ; it is yet better, if it can be 
done, to extirpate all that is fiftulous and fchirrous, 
for that is a fure way to make one operation perfe(ft 
the cure. The other kind of fifiula, im.properly fo 
called, is an abfcefs running round the outfide of the 
fphinder, in the fliape of an horfe-fhoe, being a cir- 
cle all but where this mufcle unites with thofe of the 
penis ; this is beft cured by opening and removing 
part of the outer fkin. The firft of thefe cafes 
happens ofteneft in full habits, proceeding frequent-- 
ly from the piles 3 the laft is generally a critical dif- 
charge, and one of nature's laft efforts in confamp- 
live and fcorbutic habits of body. The inverlion and 
Aiding down of this gut is called prolapfus ani, a dif- 
eafe common in children, efpecially thofe who arc 
afflided with the ftone, and of not much confe- 
quence j in men it is more rare and more danger- 
ous, being generally attended with a flux of hu- 
mours. This cafe I have cured by taking away apiece 

of 



158 DUCTUS ALIMENTALIS. 

of the prolapfed gut vvich a cauftic, lengthways of 
the gut ^ the wound difcharged the flux of humours, 
upon which the gut was eafily reduced, and cicatrif* 
ing in that ftate it never more fell down. 

I HAVE km a cafe, where a bold unthinking 
fargeon having cut off the prolapfed part, the ci- 
catrix was fo hard and contridted that the patient 
could never after go to ftool v/ithout a clyfter, and 
then not without great mifery. 

Oftentimes the piles occafion large tumors at 
the lower end of this gut -, thefe are always befl ex- 
tirpated by ligature j for if they are cut, they will 
fome times bleed exceffively, and it is no eafy mat- 
ter to apply any thing to fiop a flux of blood in that 
part. 

The guts have the fame coats with the iiomach^ 
the fibres of their middle or mufcular coat are cir- 
cular, or fpiral, and longitudinal ; of the latter but 
very few. The antagoniils to thefe mufcular fibres 
of the ftomach and guts, are their contents preffed 
from one place to another, and the mufcles of the 
abdomen, for thefe preffing upon them alter their 
form into one lefs capacious 5 which neceflarily ex* 
tends their circular fibres. The great 2;uts have 
three membranes, o^ ligaments, on the outfide run* 
ning their whole length, and fupporting the faculi, 
into which thofe guts are divided. The lefTer guts 
have, at very fm.all diftances, femilunar valves placed 
oppofite to the interftices of each other, to prevent 
the aliment from paffing too fpeedily through the 



guts 



DUCTUS ALIMENTALIS. 159 

guts ; and the better to anfwer that end, lacy are 
larger and more numerous near the flomach, wher'" 
the food is thinner, than they are towards the colon 
where the food is continually made thicker in its 
progrefs, by a difcharge of part of the chyle. This 
contrivance, fo neceffary to men becaufe of their 
ered: pofture, when they are obliged by ficknefs, 
or accidents, to lie along, becomes a great incon- 
venience, and calls for the help of clyflers and purges* 
But brutes have not thefe valves, becaufe they are 
not convenient in an horizontal pofture. At the 
entrance of the ileum into the colon, are two very 
large valves, which effeftually hinder the regrefs of 
the faeces into the ileum. But clyflers have been 
frequently knov/n to pafs them, and be vomited 
up 5 but the excrement that is fometime^ vomited 
up, I am inclined to think, is fuch as had not paf- 
fed into the great guts. The other Vcives in the co- 
lon are placed oppofite, bat not in the fame plane, 
to each other, and make with their anterior edges 
an equilateral triangle ; but as the gut approaches 
the anus, they become lefs remarkable,! and. Xow^r 
in number. y^^:>}.nii ^hl ^-o : h- • 

All the guts have in their inner membrane an 
almoft infinite number of very fmall glands: Thefe 
glands will, efpecially fome of them in the large 
guts, appear to the naked eye when they are dif- 
eafed : They are called glandulas pyerians. 

The length of the guts to that of the body h 
as five to one in a middle- fized man 3 in taller men 

the 



i6o M E S E N T E RY. 

the proportion is ufually lefs, and in fliort meri 
greater. 

Mesentery is a membrane beginning loofe- 
ly upon the loins, and is thence produced to all the 
guts : it preferves the jejunum and ileum from 
twiflirig in their periftaltic or vermicular motion, 
and confines the reft to their places. It fuftains all 
the veffels going to and from the guts, viz. arteries, 
veins, lymph^duds, lafteals, and nerves, and alfo 
contains many glands, called from their fituation 
mefentericae. The beginning of this membrane from 
the loins, is about three or four inches broad, but 
next the guts of the fame length with the fide of 
the guts they adhere to, which is in the fmall guts 
about a fourth part fhorter than the other fide ; but 
when this membrane is feparated from the fmall guts, 
it (brinks, and meafures about two thirds lefs. 

I OPENED a boy about twelve years old, that 
died of the iliac paflion, vulgarly called the twift- 
ing of the guts ; the guts, fl:omach, duodenum, 
and jejunum were diftended, with vapour and air, 
to near ten times their natural capacity, which fo 
compreflTed the inteftinum ileum, that nothing could 
pafs through it. The relations of this boy could 
give no other account of the caufe of this difeafe, 
than that of his having eaten a large quantity of 
raw young carrots. This cafe happens very fre- 
quently to lambs that have been houfed and turned 
out early in the fpring to grafs, when the grafs is 
very rank and fucculent 5 and alfo to horfes, oxen, 

and 



LIVER. I6i 

and {heep, when they happen to feed, by any acci- 
dent, upon young beans or peas, or rich clover 
grafs, which are very apt to ferment in their fto- 
machs. In thefe animals this cafe is commonly cured 
by running a knife into their guts, fome inftances 
of which I have feen, and have heard a great ma- 
ny reported 3 but this cafe happening very rarely to 
men, I believe that pradice has never yet been 
ufed 3 though the infirument w^hich is ufed for tip- 
ping in a dropfy of the abdomen, might do it with 
great eafe and fafety. Some anatomifls, who have 
confidered the impofliblHty of a twifting of the guts, 
which is the vulgar name of this difeafe, have ima- 
gined that it proceeded from one gut being involv- 
ed in another. Thefe involutions are found fre- 
quently in bodies that die a natural death, and with- 
out any inflammation, or any other fymptom of 
pain. 



C H A P T E R V. 

Of the liver ^ gall-bladder^ pancreas ^ and fplecn^ 

THE liver is the largeft gland in the body; 
,of a dufky red colour. It is iituated immb- 
diately under the diaphragm in the right hypochon- 
drium \ its exterior fide is convex, and interior con- 
cave ; backward toward the ribs it is thick, and 
thin on its'forepa.%. where it covers the upper fide 

L ' of 



i62 L I \^ E R, 

of the ftomaeb, and fome of the guts ; the uf^ef 
lide of it adheres to the diaphragm, and is alfo tyed 
to it and the flernum by a thin ligament, which is 
defcribed commonly as two ; the upper part called 
fufpenforium, and the anterior latum : but either 
of thefe names is fufficient for it all. It is alfo ty- 
ed to the navel by a round ligament called teres or 
umbilicale, v/hich is the umbilical vein degenerated 
into a ligament 5 it is inferted into the liver at a 
fmall fiffure in its lower edge. The ligamentum 
latum or fufpenforium, fuflains the liver in an ereft 
pofture, or rather fixes it in its fituation, while it 
is fupported by the other vifcera, they being com- 
prelTcd by the abdominal mufcles ^ in lying down 
the teres prevents it from preffing on the diaphi-agm ^ 
and in lying on the back, they both together fuf- 
pend it, that it may not comprefs and obftrud: the 
afcending vena cava. It is nourifhed by the branches 
of the celiac and mefentric arteries in the Hver, cal- 
led arterikE hepatic^, but its blood veflels, that com- 
pofe it as a gland, are the branches of the vena 
port'^, which enters the liver, and diftributes m 
blood like an artery, to have the bile fecreted from 
it 5 and the branches of the cava in the liver, which 
return the redundant blood into the cava afcendens ; 
It has alfo feveral branches of nerves, and a great 
number of lymphatics ; of which I (hall treat ia 
their refpedive places. Dogs and cats and other 
animals, that have a great deal of motion in their 
backs, have their livers divided into many diftinS 

lobules 5 



GALL-BLADDER. 163 

lobules 5 which by moving one againft another, com- 
ply with thofe motions, which elfe would break 
their livers to pieces. . n^k^nijT 

The gall-bladder is a receptacle of bile, feated 
in the hollow fide of the liver 5 it is compofed of 
one denfe coat fomewhat mufcular, which is co- 
vered with a membrane like that of the liver ; and 
is alfo lined with another, that cannot eafily be fe- 
parated. Modern anatomifts have defcribed a num- 
ber of fmall duds leading from the liver to the gall- 
bladder, by which they fuppofe the gall-bladder is 
filled, and thefe I thought I had fcen in a human 
body that died of a jaundice, when I was a very 
young anatomift 3 but never being able to fee any 
fince in any animal, though I have made very di- 
ligent enquiry by experiments and diffcdtion, I am 
now perfuaded that there are no fuch duds 5 for if 
they are too little to be feen or filled by injedions, 
I think they are too little for the end for which 
they are affigned. As to the argument for the ex~ 
illence of fuch duds, which is fetched from the 
difficulty of the gall-bladder's being filled through 
the duduscyfticus from the dudus hepaticus, I think 
it is of little weight, feeing the veficulae femjnales 
are filled with a thicker fluid throudi a lefs dired 
pafll^ge. From the gall-bladder towards the duo- 
denum runs a dud called cyfcicus 5 and from the 
liver to this dud one called hepaticus, which carries 
off the gall this way, when the gall-bladder is full '^^ 
then the dudus cyflicus and hepaticus being united, 

L 2 commence 



l64 GALL-BLADDER, 

commence duftus communis choledochus, whicb 
enters the duodenum obliquely about four inches 
below its beginning. Theiorifice of this dud in the 
gut is fomewhat eminent, but has no caruncle, as 
is commonly faid. As the liver, from its fituation 
in the fame cavity with the flomach, will be moft 
prelTed^ and confequently feparate moft gall when 
the ftomach is fulleft, which is the time when it is 
moft wanted; fo the gall-bladder, being feated 
againft the duodenum, it will have its fluid preffed 
out by the aliment paffing through that gut, and 
confequently at a right time and in due proportion . 
bceaule the greater that quantity of aliment is, the 
greater will be the compreffion ; and fo the con- 

I KNOW UP way of computing with any exaft-- 
nefs the quantity of bile that is ufually fecreted by 
the liver in a given time ; but if it is four times as 
much as all the falivary glands fecrete, it may be 
twenty four ounces for every meal 5 to which being 
added iix. ounces of faliva, which, from what is 
obferved ia the chapter Of the falivary glands, I 
think will appear a moderate computation. And 
fuppofing the pancreas in the fame time fecretes 
three ounces, there will then be thirty three ounces 
of fluids feparated for the digeftion of one meal ^ 
and that thefe neceflTary fluids may not be wafted in 
iuch quaiitities, they pafs into the blood with th$ 
thyl^s and may be foon feparated again for the fame 
h& y and very likely, fome of the fame bile may 

be 



PANCREAS. 165 

he employed more than once, for digefting part of 
the fame meal : And as the liver exceeds all the 
glands in the body in magnitude, and its excretory 
duds ending in the duodenum, it feems to me to 
be much more capable of making thofe large fepa- 
rations from the blood, which are procured by ca- 
thartics, than the fcarce vifible glands of the guts. 
The liver ordinarily weighs, in a middle-lized man, 
about three pounds twelve ounces, the pancreas 
three ounces, and the fpleen fourteen ounces. I 
have feen a difeafed liver in a man that weighed 
fourteen pounds four ounces ; and in a boy but nine 
years old, that died hydropic, the liver full of hy- 
datids and cyfts of hydatids adhering to it, which 
together weighed feven pounds one ounce and a half, 
though feveral pints of water had been let out of 
it before. The fpleen, in the fame boy, together 
with the hydatids contained in its membrane, weigh- 
ed three pounds. In a man I found a difeafed 
fpleen, weighing five pound two ounces ; and in an 
old man, fix foot high, I found a found liver weigh- 
ing no more than twenty eight ounces, and the 
fpleen but ten ounces : And in a man that had been 
cured of a dropfy I found a polypus very folid, al-' 
moft filling the large branches of the porta in the' 
liver, and a ftone between the liver and gall-blad- 
der, larger than a nutmeg'/^^ "^^^"^^^''*^'^ ^'-^^^- 

Pancreas, the fweet-bread, is a large gland 
of the falivary kind, lying a-crofs the upper and 
back part of the abdomen, near the duodenum ; it 

L 3 has 



i66 P A N C R E A S. 

has a (hort excretory dudt, about half as large as a 
crow qnill, though it is commonly painted as largp^ 
as the dudus communis choledqchus : It always enr 
ters the duodenum together with the bile dud j but 
in dogs fome diflance from it 5 and, I think, al- 
ways in two dcdls diftant from one another. The 
juice of this gland, together with the bile, helps to 
compleat the digeftion of the aliment, and renders 
it fit to enfer> the iadeal vefiels. In a man that died 
of a jaundice, i found the dudus communis chole- 
dochus ccmtficSed by a fchinous pancreas, the 
gall-bladdei: expended to the fize of a goofc egg^ 
and all the :dir<fls 10 twice their natural bignefs. 
This is the jCiafe in whidiT thought I had i'o plain- 
ly fctn the -cyllihepatic guts : I once faw the du- 
fius cyiiicas-obftruvSed, without the gall-bladder 
being difiended, which, I think, furnithes us with 
a very probable argument againft the exigence of 
cyftihepatic ducts. In thofe who die of the jaun- 
dice, for the moft part are found in the gall-bladder 
and the biliary duds concretions of bile fo light as 
to fwim in water, yet are called gall ftones : Thefe 
caufe the jaundice, byobftrudingtheduds; many of 
thofe who have been cored of this difeafe, have had 
great numbers of thefe ftones found in their excre- 
ments. A patient of mine, who had voided by ftool 
feveral of thefe ftones, had afterwards two of half 
an inch diameterwhich made their way through the 
integuments of the abdomen, and was cured with- 
out much pain» Oxen, as the fame gentleman in- 
formed 



SPLEEN, 167 

fGrmed me, who have been long fed upon dry meat, 
abound with them j while others, fed with them, 
and afterwards turned to graft, when killed are 
found without them. This gentleman could never 
eat any herbs. He alfo informed me of a phyfician 
in France, that with great reputation cured the 
jaundice by giving his patients large quantities of 
the juice of herbs. 

The fpleen is feated in the left hypochondrium 
immediately under the diaphragm, and above the 
kidney, between the ftomach and the ribs; it is 
fupported by the fub-contained parts, and fixed to 
its place by an adhelion to the peritoneum and dia- 
phragm 3 it is alfo conneded to the omentum, as 
has been obferved. The figure of it is a fort of de- 
prefled oval, near twice as long as bi-oad^ and almoft 
twice as broad as thick. Sometimes it is divided in- 
to lobules, but for the moft part has only one or two 
fmall fiffures on its edge, and fometimes none ; in 
its colour it refembles cafl iron. The inner texture, 
in brutes, is veficular, like the penis; in which 
veficles are found grumous blood, and fmall bodies 
like glands: But Ruysch denies that the human 
fpleen is of the fame texture. The fpleen I have 
feen taken out of a dog, without any remarkable 
inconvenience to him. I have twice, in a human 
body, feen three fpleen?, twice two, and once four; 
fome of thefe were very fmall, others nearly equal, 
but altogether in any of thefe bodies were not larger 
than the one which is ufually found, '^q-;. 

L4 CHAPTER 




368 V A S A L A C T E A, 

CHAPTER VI. 

Of the vafa Ja^ea, 

ASA LAC TEA are the venaB ladese, rc^ 
ceptaculum chyli, and dudus thoracicus. 

Ven^. LACTEJE, &c. are a yaft number of 
very fine pellucid tubes, beginning from the fmall 
guts, and proeeeding thence through the mefentery 5 
they frequently unite, and form few^er and larger 
veflels,. which iirfl: pafs through the mefenteric 
glands, and then into the receptaculum chyli. 
Thefe veffeis e'er they arrive at the mefenteric glands, 
or in dogs the pancreas afellii, which is thefe glands 
coUefted, are called venis ladea^ primi generis 5 and 
thence to their entrance into the receptaclum chyli, 
i^enx latleasfeciindi generis. The office of thefe 
veins is to receive the fluid part of the digefted ali- 
ment, which is called chyle, and cpnvpy it to the 
receptaculum chyli, that it may be thence carried 
through th€ du6tas thpracicus into the blood veffeis. 

For the following excellent defciipdon, thus 
mai'ked '^, of the receptaculum chyli, and dudus 
thoracicus, I am^obfeed to Mr. Monro, 

.*^ Receptaculltm chyli, Pecquet I, or 
*^ SACCus LACTEus Yan HoRNE, isamembraT, 
^^ nous fomewhat pyriform bag, two thirds of an 
^^ inch long, one third of an inch over in its largeft 
'*■ part, when coUapfed; fituatcd on the firft vertebra 
*' lumbrorum, to the right of the aorta, a little higher 

">' thari 



V A S A L A C T E A. 169 

^* than the arteria emulgens dextra, under the right 
^^ inferior mufcle of the diaphragm, it is formed 
" by the union of three tubes •> one from under the 
^* aorta, the fecond from the interilice of the aorta 
" and cava, the third from under theemulgents of 
" the right fide. The faccus chyliferus at its fupe- 
" rior part becoming gradually fmaller, is contract- 
'^ ed into a (lender membranous pipe of about a 
^\ line diameter, well known by the name of 

" Ductus TKORACicus 5 This palTes betwixt 
'^ the appendices mufculofas diaphragmatis, on 
" the right of, and fomewhat behind the aorta, 
*' then lodged in the cellular fabftance under the 
" pleura ; it mounts between this artery and vena 
*' fine pari, or azygos, as far as the fifth vertebra 
*' thoracis, where it is hid by the azygos, as this 
^* vein rifes forward to join the cava defcendens ; 
" after which the dud: palTes obliquely over to the 
*' left fide under the csfophagus, aorta defcendens, 
** and great curvature of the aorta, an til it reaches 
** the left carotide, ftretching farther towards the 
*' left internal jugular, by a circular turn, v/hofe 
"*' convex part is uppermoft ; at the top of this arch 
'' it fplics into tvv^o for one half Jine., the fuperior 
" branch receiving into it a large lymphatic from 
'^ the cervical glands. This lymphatic appears, by 
'* blowing and injedions, to have two valves 5 
*^ when the two branches are united, the dud con- 
" tinues its courfe to the internal jugular, behind 
*? which it defcends, and imm^ediately at the left 

" fide 



ijo VA S A L A C T E A. 
« fide of the infeition of this vein, enters the fu- 
«< perior and pofterior part of the left fubclavian, 
*« whofe internal membrane daplicated forms a fe- 
<« milunar externally convex valve that covers two 
<^ thirds of the orifice of the Audi ^ immediately 
<« below this orifice a cervical vein from the muf- 
« culi icaleni enters the fubclavian. The thin coat 
« and valves, commonly ten or twelve, erf this dud: 
^^ are fo generally known, I need not mention them, 
^« In my notes 1 find little variation in the recepta- 
" culum, only its different capacities in different 
« fubjecls, and fometimes more duds concurring in 
«' the formation of it. The diameter of the dud: 
*« varies in moft bodies, and in the fame fubjed is 
" uniform, but frequently fudden enlargements or 
<^ facculi of it are obfervable.- The divifions which 
^« authors mention of this dud within the thorax 
" are very uncertain : In a woman I diffeded lafl 
«^« fummer, at the eighth vertebra thoracis, one 
" branch climbed over the aorta, and about the 
" fifth vertebra flipped back again under that artery 
«^ to the other branch, which continued in the or- 
*-* dinary courfe. Lafl winter I found this dud of 
*^ a man difcharging itfelf intirely into the right 
^« fubclavian vein. The precife vertebra, where it 
*' begins to turn towards the left, is alfo uncertain. 
** Frequently it does not fplit at its fuperior arcb^ 
^ m v/hich cafe a large faccus is found near its a- 
" perture into the fubclavian vein. Generally it has- 
" but one orificCj though I have fcen two in one 

** body. 



VASA LACTEA. 171 

^f body, and three in another j nay, fometimes it di- 
■«« vides into two under the curvature of the great 
^^ artery, one goes to the right, another to the left 
^^ fubclavian ; this however is very rare. The lym- 
«^ phatic, which enters the fuperior arch, is often 
** fent from the thyroide gland/' 

Supposing there ordinarily paffes five pounds 
of chyle in a day through the ladleals, and that 
four ounces of this only are added to the blood (tho' 
it may be any other quantity for ought I know) 
and that a man neither decreafes or encreafes during 
this time, then all the feparations from the fluids 
and folids muft be juft five pounds j four ounces 
of which muft be thofe fluids and particles of fo- 
lids, which are become unprofitable ; and the re- 
maining four pounds twelve ounces will ferve as a 
vehicle to carry the four ounces off: So that we fee 
for what reafon more fluids are carried into the blood 
than are to be retained there, and how the body is 
by the fame means both nouriOied and preferved in, 
health. ,:d baqaill ^-ids: 






gMAVTMK 

■n.r iJJLn ■ Jit J • .iU 



X72 PLEURA, MEDIASTINUM, 

CHAPTER VIL 

Of the pleura^ mediajiimm^ lungs ^ pericardium y and 

hearty 

PLEURA is a fine membrane which lines 
the whole cavity of the thorax, except on the 
diaphragm, which is covered with no other than 
its own proper membrane. The back part of it is 
extended over the great veffels, like the peritoneum ^ 
and in regard this membrane pafles partly under 
thefe veffels, as the peritoneum does in the abdo- 
men, they may be faid to lie in a dapiicature of it^ 
it ferves to make the infide of the thorax fmooth 
and equalpisb iKioDdi^T?- 

MEDiA^sTiKtJM divides the thorax lengthways, 
from the fternum to the pericardium and pleura^ 
which is a very fhort fpace, but in many brutes very 
confiderable. It divides into two m men, but in 
brutes it is Angle 5 it divides the thorax not exacft- 
ly in the middle, but towards the left fide, and is 
fo difpofed, that the two cavities, into which it di- 
vides the thorax, do not end toward this membrane 
in an angle, but a fegment of a circle ; it hinders 
one lobe of the lungs from incommoding the other^ 
as in lying on one fide the uppermoft might do 5 and. 
prevents the diforders of one lobe of the lungs from 
affe6:ing the other. 

The lungs are compofed of two lobes, one feat- 
ed on each fide of the mediaftinum \ each of which 

lobes 



DUNG-S. 173 

lobes are fubdivlded into two or three lobules, which 
are moft diflindly divided in fuch animals as have 
moft motion in their backs, for the fame end that 
the liver is in the fame animals. They are each com- 
pofed of very fmall cells, which are the extremi- 
ties of the afpera arteria or bronchos. The figa re 
of thefe cells is irregular ; yet they are fitted to each 
other fo as to have common fides, and leave no void 
fpace. Into thefe cells the blood- veiTels difcharge a 
large quantity of lymph, or materia perfpirabilis, 
which at once keeps them from being dried by 
the aif, and makes a large and neceffary difcharge 
from the blood, as has already been obferved upon 
the fubjedl of perfpiration through the fkin. Dr. 
Willis has given a very particular defcription of 
the inner texture of the lungs, but it is only ima- 
ginary and falfe, as he, and they who have copied 
his cuts and defcriptions could not but have known, 
if they had ever made the leaft enquiry into the lungs 
of any animal ; nor is his account of the lympha- 
tics on the furface of the lungs, at all more true 
than that of their texture. In the membranes 
of thefe ceils are diftributed the branches of the 
pulmonary artery and vein. The known ufes of 
the air's entering the lungs, are to be inftrumental 
in fpeech, and to convey eiBuvia into the nofe, as 
it paffes for the fenfe of fmelling ; but the great 
ufe of it, by which hfe is preferved, I think, we 
do not underftand. By feme the force of the air Is 
thought to feparate the globuli of the blood that 

have 



174 L tj N G g. 

jhave cohered in the flow circulation through th^ 
veins ; and this opinion feems to be favoured by th^ 
many inftances of polypufes, which are large 
concretions of the globuli of the blood, found in 
the veins near the heart, and in the right auricle 
and ventricle of the heart ^ and their being fo feldom 
found in the pulmonary veins, or in the left auricle 
or ventricle of the heart, or in any of the arteries i 
but if it is true that, while the blood pafles thro' 
the lungs, many cohering globuli are feparated, yet 
it remains to be proved that thefe feparations are 
made by the force of the air. Dr. Keil has com- 
puted the force of the air in the ftrongeitexfpirations 
againil; the fides of ail the veficles, to be equal to 
fifty thoufand pound weight, which though we 
fhould grant, we (hall ftill find the moment of the 
air in the lungs exceeding fmall in any fmall fpace. 
For the velocity with which the air moves in the 
lungs is as much lefs than that with which it moves 
in the wind-pipe, as the fqu are of a fedion of the 
cells in the lungs is greater than the fquare of a fee* 
tion of the Vv'ind-pipe; and therefore if the fquare 
of all the extreme blood- veffels in the lungs do not 
bear a greater proportion to the fquare of the large 
pulmonary vefiels than the fquare of the cells do to 
the wind-pipe, and if the blood in thefe large vef- 
fels moves as fafl as the air in the wind-pipe, then 
the blood moving in the fnialleft veffels of the lungs 
with a velocity equal to that of the air in the cells, 
the blood will have as much more attrition from 

the 



LUNGS. 175 

the power that moves it in its own veflels, than the 
air can give upon them, as blood is heavier than 
air. Befides, air preffing equally to all fides, and 
the globuli of the blood fwimming in a fluid 3 this 
preflure, be it what it will, I think, can be of lit- 
tle ufe to make fuch reparations. Indeed it may 
be objeded that the greateft preflure is in exfpira- 
tion, yet that furely cannot be very great, while 
the air has fo free a paflage out of them. Others 
have thought that the air enters the blood-veffels 
from the cells in the lungs, and mixes with the 
blood ; but this opinion, however probable, wants 
fufficient experiments to prove it; air being found 
in the blood, as it certainly is, is no proof of its 
entering this way, becaufe it may enter with the 
chyle : Nor is the impoflibility which has been 
urged of its entering at the lungs without the blood 
being liable to come out the fame way into the ve- 
ficles of the lungs, a good argument to the contra- 
ry ; for if a pliable dudt pafles between the mem-, 
branes of a veflel, through a fpace greater than 
the fquare of its orifice, no fluid can return, becaufe 
the prefiiire which fhould force it back will be 
' greater againfl: the fides of that dud than its orifice; 
which is the cafe of the bile dud entering the duo- 
denum, and the ureters entering the bladder. I 
think the mofl: probable argument for the aire's en- 
tering into the blood by the lungs, or rather fome 
particular part of the air, may be fetched from a 
known experiment of each in.^a in a diving bell 
3 wanting 



176 LUNG S. 

wanting near a gallon of frefh air in a minute • afid 
if preiTure only was wanted in this cafe, they often 
defcend, till the prefilire of the air is three or four 
times what it is upon the furface of the earth, with- 
out any advantage from that preffure • and animals 
dying fo foon in air that has been burnt^ and their 
being fo eafily intoxicated by breathing air much 
impregnated with fpirituous liquors, are alfo argu- 
ments of a paffage this way into the blood. Befides, 
if preffure of the air in the cells of the lungs is the 
only ufe of it, I do not fee but enough of that 
may be had while a man is hanging, if the mufcles 
of the thorax do but ad: upon the air which was 
left in the thorax when the rope was firft fixed, 
and yet death is brought about by hanging no other 
way than by interrupting of the breath, as I have 
found by certain experiments. Dr. Drake has 
endeavoured to fhev/, that the ufe of refpiration is 
to afiift the fyliole of the heart ; but this ufe re- 
quires that the fyflole and dialiole of the heart 
should keep time with exfpiration and infpiration, 
which is contrary to experience. The lungs of 
animals before they have been dilated with air, are 
fpecifically heavier than Vv^ater, but upon inflation 
they become fpecifically lighter, and fwim in water 9 
which experiment may be made to difcover whe- 
ther a dead child was flill born, or not ; but if the 
child has breathed but a little, and the experiment 
is made long after, the lungs may be collapfed 
and grow heavier than water, as I have experiment- 
ed, 



Pericardium AND HEART. 177 

ed, which may fometimes lead a man to give a 
wrong judgment in a court of judicature, but theii 
it 'will be on the charitable fide of the queftion. 
Adhefions of the lungs to the pleura are in men 
fo common, I know not how to call it a difeafe; 
they being found fo more or lefs in moft adult per- 
fons, and without any inconvenience, if the lungs 
are not rotten. 

Pericardium, or heart-purse, is an ex- 
ceeding flrong membrane which covers the heart ; 
its fide next the great veflTels is partly connefted to 
them, and partly to the bafis of the heart, but, I 
think, not properly perforated by thofe vefiTels j and 
its lower fide is infeparable from the tendinous part 
of the diaphragm, but not fo in brutes, in fome 
of which there is a membranous bag "between it 
and the diaphragm, v/hich contains a lobule of the 
lungs. It enclofes all the heart to its bafis ; its ufes 
are to keep the heart in its place without interrupt- 
ing its office, to keep it from having any friction 
with the lungs, and to contain a liquor to lubricate 
the fur face of the heart, and abate its friction 
againft the pericardium. 

The heart is a mufcle of a conic figure, with 
two cavities or ventricles; its bafis is fixed by the 
veflels going to and from it, upon the fourth arid 
fifth vertebras of the thorax ; its apex, or point, 
is inclined downward and to the left fide, where 
it is received in a cavity of the left lobe of the 
lungs, as may be obferved, the lungs being extend- 



178 HEART. 

ed with air. This incumbrance on the left lobe of 
the lungs, I imagine, is the caufe of that fide's be- 
ing moft fubjed: to thofe pains which are ufually 
called pleuritic, which I have ever found upon dif- 
fering of them to be inflammations in the lungs. 

At the bafis of the heart, on each fide, are litu- 
ated the two auricles to receive the blood 5 the right 
from the two venae cavas, and the left from the pul- 
monary veins: In the right, at the meeting of the 
cavae, is an eminence called tuberculum Lower i^ 
which direfts the blood into the auricle ; imme- 
diately below this tubercle, in the ending of the ca- 
va afcendens, is the veftigium of the foramen ova- 
le (vid. chap. Of the foetus }) and near this, in the 
auricle, is the mouth of the coronary veins. Both 
auricles are ftrengthened by mufcular columns^, like 
the ventricles. The left is much lefs than the rights 
but the difference is fupplied by a large mufcular 
cavity, which the veins from the lungs afford in that 
place. The fides of this mufcular cavity are thicker 
than the fides of the right auricle, in about that 
proportion, in which the left ventricle of the heart 
is ftronger than the right ; their ufes being to re- 
ceive blood from the veins that lead to the heart, 
and prefs it into the ventricles, a flrength in each 
auricle proportionable to the ftrength of the ventricle 
that it is to fill with blood, feems neceffary : And 
thi& different thicknefs of the coats of the auricles 
makes the blood in the left, which is thickefl, ap- 
pear through it of a paler red ; but when it is let 

out 



HEART, 179 

out of the auricles, it appears alike from both -, which 
they would do well to examine, who affirm the 
blood returns from the lungs of a more florid co- 
lour than it went in 5 and offer it as an argument 
of the blood's being mixed with air in the lungs. 
The ventricles or cavities in the heart which receive 
the blood, are hollow mufcles, or two cavities in 
one mufcle, whofe fibres interfedl one another, fo 
as to make the preflure of the heart upon the blood 
more equal and effedual, and are alfo lefs liable to 
be feparated than they would have been, if they 
had lain in one diredlion. Both thefe cavities receiv- 
ing the fame quantities of blood in the fame times, 
and always acting together, muft be equal in fize, if 
they equally difcharge what they contain at every 
fyftole, as I doubt not but they do ; neverthelefs 
the left appears lefs than the right, it being found 
empty in dead bodies, and the right ufually full of 
blood 3 which made the ancients think the veins 
and the right ventricle only were for the blood 
to move in, and that the left and the arteries con- 
tained only animal fpirits. The left ventricle is mjjch 
the thickeft and lirongefl, its office being to drive 
the blood through the v/hoie body, while the right 
propels it through the lungs only. Over the en- 
trance of the auricles in each ventricle, are placed 
valves to hinder a return of blood while the heart 
contrads, Thofe in the right ventricle are named 
tricufpides, thofe in the left mitrales. One of thefe 
laft feems to do further fervice, by covering the 

M 2 mouth 



i8o HEAR T. 

mouth of the aorta while the ventricle fills ; which 
fuffering none of the blood to pafs out of this ven- 
tricle into the aorta before the ventricle ads, it will 
be able to give greater force to the blood than it o- 
therwife might have done -, becaufe a greater quan- 
tity of blood more fully diilending the ventricle, 
and making the greater refiftance, it will be ca- 
pable of receiving the greater impreffed force from 
the ventricle j and if the blood is no way hindered 
in the right ventricle from getting into the pulmo- 
nary artery, while the ventricle dilates, as it is in the 
left, the left then may be fomewhat bigger than 
the right, if they both empty themfelves alike in 
every fyftole. Though the auricles of the heart 
are equal to each other, and the two ventricles alfo 
equal, or nearly equal, yet the auricles are not fo 
large as the ventricles 5 for the ventricles contain 
not only all the blood which flowed from the veins 
into the auricles, during the con traftion of the heart, 
^ but alfo that which flows (which will be diredlly 
into the heart) while the auricles contradl, and the 
-ventricles dilate 5 which leads us to the exad know- 
ledge of the ufe of the auricles. If the fyfl:ole and 
diaftole of the heart are performed in equal times^ 
ihen the auricles mufl be half the flze of the ven- 
- tricles ; or whatever proportion the fpace of time 
of the fyftole of the heart bears to the fpace in 
which the lyflole and diaftole are both perform- 
ed, that proportion will the cavities of the auricles 
bear to the cavities of the ventricles. The inner 

fibres 



HEART. i8i 

fibres of each ventricle are difpofed into fmall cords, 
which are called columns: From fome of thefe 
ftand fmall portions of fleih called papilte ; thefe 
papilte are tied to the valves by flender fibres, where- 
by they keep the valves from being prefled into the 
auricles by the adion of the blood againfl them 
in the fyftole of the heart ; and when that is over, 
the blood flowing in between them opens them, as 
the prelTare of blood on the other fide fhuts them 
in the iyftole. For the courfe of the blood through 
this part, vid. chap. Of the courfe of the aliment 
and fluids. In the beginning of each artery from 
the heart are placed three valves, which look for- 
ward, and clofe together to hinder a regrefs of blood 
into the ventricles. Thofe in the pulmonary ar- 
tery are named figmoidales, thofe in the aorta, fe- 
milunares. For the canalis arteriofus, vid. chap. Of 
the foetus. 

In a boy I found a great quantity of pus in the 
pericardium, and the bafis of the heart ulcerated. 
In perfons that have died of a dropfy, I have ufu- 
ally obferved the heart large, its fibres lax, and the 
velTels about it immoderately diftended, and poly- 
pufes fometimes in both auricles and ventricles, and 
in the large veins -, but more frequently in the right 
auricle and ventricle. Mr. Pile has prepared a 
heart thus difeafed, whofe circumference from the 
vertex round the bafe of the auricles meafures twenty 
four inches and a quarter, and round the bafe of 
the ventricles feventeen inches and an half, I dif- 

M 3 iefl:ed 



i82 HEART. 

feded a man that died tabid, in whom the peri- 
cardium univerfally adhered to the heart, and a 
portion of the mufcular part of the heart was offi- 
fied as large as a fix-pence. The beginning of the 
aorta is frequently {cqxi offified, efpecially in aged 
perfons. In a woman that died of a dropfy, I found 
the valves of the aorta quite covered with chalk- 
ftones, which not fuffering the valves to do their 
office, the left ventricle of the heart was conftant- 
ly overcharged with blood, and diftended to above 
twice its natural bignefs, which, I imagine, deftroy- 
ed the ceconomy of the body, and occafioned the 
dropfy. 

Upon opening the body of a perfon who died 
with excefiive palpitations of the heart and uneven 
pulfe, which began after very hard drinking in ex- 
treme hot weather fome yeais before, I found about 
ten inches of the aorta neareil the heart diftended 
three times its natural diameter ; and in a man one 
hundred and three years old, I found the fame part 
of the aorta extended twice its natural capacity, 
without any fymptom of fuch a diforder when liv- 
ing. 



CHAPTER 



ARTERIES AND VEINS. 183 

CHAPTER VIII. 

0/ tJoe arteries and veins. 

FROM the right ventricle of the heart arifes 
the pulmonary artery, which foon divides 
into two branches, one to each lobe of the lungs ; 
then they iiibdivide into fmallerandfnialler branches, 
until they are diftributed through every part of the 
lungs. From the extreme branches of the pulmo- 
nary artery arife the fmall branches of the pulmo- 
nary veins i which, as they approach the left au- 
ricle of the heart, unite in fuch a manner as the 
pulmonary artery divides going from the heart, on- 
ly that the veins enter the mufcular appendix of the 
left auricle in feveral branches, and the blood being 
brought back from the lungs by thefe veffels to the 
left auricle and ventricle of the heart, it is from 
the left ventricle of the heart thrown into the 
aorta. 

Aorta, or great artery, arifes from 
the left ventricle of the heart, and deals out branches 
to every part of the body. The firft part of this 
vejffel is called aorta afcendens; it pafles over the 
left pulmonary artery, and veins, and branch of the 
afpera arteria, and being reflected under the left lobe 
of the lungs, it commences aorta defcendens 5 which 
name it keeps through the thorax and abdomen, 
where it paffes on the left fide of the fpine, till its 

M 4 divifion 



184 ARTERIES AND VEINS. 
divifion into iliac arteries between the third and 
fourth vertebra of the loins. 

From under two of the femilunar valves of the 
aorta, which is e'er it leaves the heart, arife two 
branches (fometimes but one) which are beftov/ed 
upon the heart, and are called coronariae cordis. 
From the curved part of the aorta, which is about 
two or three inches above the heart, arife the fub- 
clavian and carotid arteries 5 the right fubclavian and 
carotid in one trunk, but the left fingle. By fome 
authors thefe veilels have been defcribed in a dif- 
ferent manner, but I believe their defcriptions were, 
for want of human bodies, taken from brutes ; for 
I have never yet feen any variety in thefe veffels in 
human bodies, though I have in the veins nearer 
the heart : And indeed there feems to me to be a 
mechanical reafon for their going off in the man- 
ner here defcribed, in human bodies ; for the right 
fubclavian and carotid arteries neceffarily going oft 
from the aorta at a much larger angle than the left, 
the blood would niove more freely into the left than 
the right, if the right did not go off in one trunk, 
which gives lefs fridion to the blood than two 
branches equal in capacity to that one ; fo that the 
advantage the left have By going off from the aor- 
ta at much acuter angles than the right, is made 
up to the right by their going off at firfl in but one 
branch. 

The carotid arteries run on both fides the la- 
rynx to the fiXth foramina of the fcull, through 

which 



ARTERIES AND VEINS. 185 

which they enter to the brain ; but as they pafs 
through the neck, they detach branches to every 
part about them, which branches are called by the 
names of the parts they are beftowed upon ; as, 
laryngeae, thyroide^, pharynges, linguales, tem- 
porales, occipitales, faciales, &c. but juft before they 
enter the fixth foramina of the fcull, they each 
fend a fmall branch through the fifth foramina 
to that part of the dura mater which contains 
the cerebrum. It is thefe arteries which make 
thofe impreffions which are conftantly obferved on 
the infide of the ofla bregmatis : Thefe branches^ 
Mr. Monro obferves, oftner arife from the tem- 
poral arteries, The internal carotids fend two branches 
to the back part of the nofe, and feveral branches 
through the firfl: and fecond foramina of the fcuU 
to the face and parts contained within the orbits of 
the eyes, and then piercing the dura mater, they 
each divide into two branches, one of which they 
fend under the falx of the dura mater, between 
the two hemifpheres of the brain, and the other^ 
between the anterior and pofterior lobes. Thefe 
branches take a great many turns, and divide into 
very fmall branches in the pia mater before they 
enter the brain, as if the pulfe of larger arteries 
would make too violent an impreffion on fo tender 
and delicate a part. And perhaps it may be from 
an increafe of the impulfe of the arteries in the 
brain, which ftrong liquors produce, that the nerves 
are fo much interrupted in their ufes throughout the 

whole 



a86 ARTERIES AND VEINS. 

whole body, v/hen a man is intoxicated with drink- 
ing J and may it not alfo be from a like caufe that 
men are delirious in fevers ? Befides thefe two ar- 
teries, viz. the carotids, the brain has two more, 
called cervicales, which arife from the fubclavian 
arteries, and afcend to the head through the fora-- 
mina, in the tranfverfe proceiTes of the cervical 
vertebrs, and into the fcuU through the tenth or 
great foramen. Thefe two arteries uniting foon af- 
ter their entrance, they give oit branches to the 
cerebellum, and then paffing forward, divide and 
communicate with the carotids; and the carotid 
arteries communicating with each other, there is an 
entire communication between them all ; and thefe 
communicant branches are fo large that every one 
of thefe four great veflels, with all their branches, 
may be eafily filled with wax through any one of 
them. 

The fubclavian arteries are each continued to 
the cubit in one trunk, which is called axillaris as 
it pafles the arm- pits, and humeralis as it pafles by 
the infide of the os humeri, between the mufcles 
that bend and extend the cubit. From the fub- 
clavians within the breall; arife the arterias mamma- 
ris, which run on the infide of the fternum, and 
lo¥/er than the cartilago enfiformis. Soon after the 
arteria humeralis has paiTed the joint of the cubit, 
it divides into two branches, called cubitalis fupe- 
rior, and cubitalis inferior ; which latter foon fends 
ofta branchy called cubitaljs media, which is beflow- 

ed 



ARTERIES AND VEINS. 187 
cd upon the mufdes feated about the cubit. The 
cubitalis fuperior paffes near the radius, and round 
the root of the thumb, and gives one branch to 
the back of the hand, and two to the thumb, one 
to the firft finger, and a branch to communicate 
with the cubitalis inferior. The cubitalis inferior 
paffes near the ulna to the palm of the hand, where 
it takes a turn, and fends one branch to the outfide 
of the little finger, another between that and the 
next finger, dividing to both, another in the fame 
manner to the two middle fingers, and another to 
the two fore fingers. Thefe branches which are 
beftowed on the fingers run one on each fide of each 
finger internally to the top, where they have fmall 
communications, and very often there is a branch 
of communication between the humeral and infe- 
rior cubital arteries. This comm.unicant branch is 
fometimes very large, and liable to be pricked by 
carelefs or injudicious blood-letters, in bleeding in 
the bafilic vein, imm^ediately under which, as far 
as I have been able to obferve, this branch always" 
lies. Mr. Monro has found the fubclavian artery 
divided in one fubjedt into two, the exterior of 
which formed the cubitalis fuperior, and the inner 
artery, the cubitalis inferior 5 from which ftrudure 
he accounts for the fuccefs in the operation of the 
aneurifm fometimes performed above the cubit. 
When the operation for an aneurifm is made upon 
this communicant branch, it is found neceffary to 

tie 



i88 ARTERIES AND VEINS. 

tie it on both fides of the orifice, becaufe the blood 
is liable to flow freely into it either way. 

From the defcending aorta on each fide is fent 
a branch under every rib^ called intercoftalis, and 
about the fourth vertebra of the back it fends off 
two branches to the lungs, called bronchiales, which 
are fometimes both given off from the aorta, fome- 
times one of them from the intercoflal of the fourth 
rib on the right fide ; and as the aorta paflTes under 
the diaphragm, it fends two branches into the dia- 
phragm, called arterise phrenicae, which fome- 
times rife in one trunk from the aorta, and fome^ 
times from the cceliaca; but oftner the right from 
the aorta, and the left from the cceliac. Immedi- 
ately below the diaphragm arifes the cceliac artery 
from the aorta ; it foon divides into feveral branch- 
es, which are beflowed upon the liver, pancreas, 
fpleen, ftomach, omentum, and duodenum. Thefe 
branches are named imm the parts they are be flowed 
on, except two that are beflowed upon the flomach, 
which are called coronaiia fuperior and inferioi*, and 
the branch beflowed upon the duodenum, which is 
named inteftinalis. At a very fmall didance below 
the arteria coeliaca from the aorta arifes the mefente- 
rica fuperior, whofe branches are beflowed upon ail 
the inteflinum jejunum and ileum, part of the co- 
lon, and fometimes one branch upon the liver. A lit- 
tle lovi^e.r than the fuperior mefenteric artery arife 
the emulgents, which are the arteries of the kid- 
neys* And a little lower than the emulgents, for- 
ward 



ARTERIES AND VEINS. 189 
Ward from the aorta, arife the arterias fpermatic^ ^ 
for which, vid. chap. Of the parts of generation 
in men. Lower laterally the aorta fends branch- 
es to the loins, called lumbalesj and one forward, 
to the lower part of the colon and the redum, cal- 
led mefenterica inferior. Between the arteria coeli- 
aca, mefenterica fuperior and inferior, and the 
branches of each near the guts, there are large com- 
municant branches to convey the blood from one 
to another, when they are either comprelled by 
excrements, or from any other caufe. 

As foon as the aorta divides upon the loins, it 
fends off an artery into the pelvis upon the os fa- 
crum, called arteria facra, and the branches the 
aorta divides into are called iliacae, which in about 
two inches fpace divide into external and internal. 
The iliacs internas firft fend off the umbilical ar- 
teries which are dried up in adult bodies, except at 
their beginnings, which are kept open for the col- 
lateral branches on each fide, one to the bladder, 
and one to the penis in men, and in women the 
uterus : The reft of thefe branches are beftowed upon 
the buttocks and upper parts of the thighs. The 
iiiacs externa run over the offa pubis into the thighs ; 
and as they pafs out of the abdomen they fend off 
branches, called epigaftricse, to the forepart of the 
integuments of the abdomen under the redti mufcles. 
And the epigaftric arteries fend each a branch into 
the pelvis and through the foramina of the offa'in- 
nominata to the mufcles thereabouts. As foon as 

^ the 



I90 ARTERIES AND VEINS. 
the iliac artery is pailed out of the abdomen into 
the groin it is called inguinalis, and in the thigh 
cruralis, where it fends a large branch to the back 
part of the thigh ; but the great trunk is continued 
internally between the flexors and extenfors of 
the thigh, and paffing through the infertion of the 
triceps m.ufcle into the ham, it is there called po- 
plitea ; then below the joint it divides into two 
branches, one of which is called tibialis antica ; it 
pafTes between the tibia and fibula to the fore part of 
the leg, and is beftowed upon the great toe, and one 
branch to the next toe to the great one, and an- 
other between thefe toes to communicate with the 
tibialis poftica; which artery, foon after it is di- 
vided from the antica, fends off the tibialis media, 

. which is beftowed upon the mufcles of the leg ; 
the tibialis poftica goes to the bottom of the foot 

. and all the leffer toes. The tibialis antica is dif- 
pofed like the cubitalis fuperior^ the poilica like the 
cubitalis inferior 5 and the media in each have alfo 
like ufes. Thefe arteries, which I have defcribed, 
are uniform in moft bodies, but the leffer branches 
are diflributed like the branches of trees, in fo dif- 
ferent a manner in one body from another, that it 
is highly probable no two bodies are exactly alike, 
nor the two fides in any one body. 

I HAVE once feen a rupture of matt-er, and 
once of blood and matter, which flowed out of 
the abdomen into the fore part of the thigh, thro' 

the 



ARTERIES AND VEINS. 191 

the fame paffage at which the iliac artery goes out 
of the abdomen. 

The veins arife from the extremities of the ar- 
teries, and make up trunks which accompany the 
arteries in almoft every part of the body, and have 
the fame names in the feveral places which the ar- 
teries have, which they accompany. The veins of 
the brain unload themfelves into the finufes (vid. 
chap. Of the dura and pia mater) and the fi- 
nufes into the internal jugulars and cervicals, and 
the internal jugulars and cervicals into the fubcla- 
vians, which joining, make the cava defcendens. 
The internal jugulars are feated by the carotid ar- 
teries, and receive the blood from all the parts which 
the carotids ferve, except the hairy fcalp and part 
of the neck, whofe veins enter into the external 
jugulars, which run immediately under the muf- 
culus quadratus gense, often two on each fide. The 
cervical veins defcend two through the foramina 
in the tranfverfe proceffes of the cervical vertebra, 
and two through the great foramen of the fpine, 
and one on each fide the fpinal marrow -, thefe join 
at the lowed vertebra of the neck, and then em- 
pty into the fubclavians, and at the interflices of all 
the vertebrae communicate with one onother. 

The veins of the limbs are more than double 
the number of the arteries, there being one on each 
fide each artery, even to the fm.alleft branches that 
we can trace, befides the veins w^hich lie imme- 
diately under the fkin, Thofe which accompany the 

I arteries, 



\t)i ARTERIES AND VEINS. 

arteries, have the fame name with the arteries ; thofe 
which run immediately under the ficin on the back 
of the hand, have no proper names 5 they run from 
thence to the bend of the elbow, where the up- 
permofl is called cephalica, the next mediana, the 
next bafilica. Thefe all communicate near the 
pint of the elbow, and then fend one branch which 
is more diredly from the cephalica, and bears that 
name until it enters the fubclavian vein ; it paffes 
immediately under the fkin, in moft bodies, be- 
tvv^een the flexors and extenfors of the cubit, on the 
upper fide of the arm. The other branches joining 
and receiving thofe which accompany the arteries 
of the cubit, they pafs with them by the artery 
of the arm into the fubclavian vein. The external 
veins have frequent com.munications with the in- 
ternal, and are always fulled when we ufe the 
moft exercife ; becaufe the blood being expanded by 
the heat which exercife produces, it requires the 
veflels to be diftended, and the inner veffels being 
compreffed by the actions of the mufcles, they 
cannot dilate enough ; but thefe veiTels being feated 
on the outiides of the mufcles, are capable of be- 
ing much dilated 5 and this feems to me to be the 
hief ufe of thefe external veffels. The cephalic 
vein, as it runs up the arm, is very vifible in moft 
men, but in children is rarely to be feen 5 there- 
fore great care iliould be taken not to wound it in 
the cutting of ifiues in childrens arms 5 and I know 
TiO way to be fure of avoiding it, but by cutting the 

iffue 



c 



ARTERIES AND VEINS. 193 
iffue more externally than is ufual in men, which 
may be done without any inconvenience. 

In the thorax, befides the two cavas, there is a 
vein called azygos, or vena line pari ; it is made up 
of the intercoftal, phrenic, and bronchial veins, 
and enters the defcending cava near the auricle, as 
if its ufe was to divert the defcending blood from 
falling too diredtly upon the blood in the afcending 
cava, and direcfl the blood of the defcending cava 
into the auricle; 

In the abdomen (befides the cava afcendens and 

the veins which are named like the arteries, viz. 

the emulgents from the kidneys, the lumbal and 

fpermatic veins, the facra, iliac, and hypogaftric 

veins) there is one large one called vena portal, whofe 

branches arife from all the branches of the cceliac 

and two mefenteric arteries, except thofe branches 

of the coeliac and fuperior mefenteric, which are 

beftowed on the liver^ and uniting in one trunk 

enters the liver, and is there again diftributed like an 

artery, and has its blood colleded and brought into 

the cava by the branches of the cava in the liver 5 

this vein being made ufe of inllead of an artery to 

carry blood to the liver, for the feparation of bile.. 

It moves here about eight times flower than in the 

arteries hereabouts; and this flow circulation being 

fuppofed neceflary, I think, there feems no other 

way fo fit to procure it 3 for if an artery had been 

employed for this ufe, and been thus much dilated 

in fo (hort a paflage, the blood v/ould not have 

N moved 



194 ARTERIES AND VEINS. 

moved (o uniformly in it, but fafter through Its 
axis than near its fides 3 and befides, it is very pro- 
bable that the blood in this vein having been firft 
employed in nourifliing feveral parts, and having 
through a long fpace moved flowly, may be made 
thereby fitter for the feparation of bile, than blood 
carried by an artery dilated to procure a circula- 
tion of the fame velocity v^ith that in this vein. 

In the leg the veins accompany the arteries in 
the fame manner as in the arm, the external veins 
of the foot being on the upper fide, and from them 
is derived one called faphena, which is continued 
on the infide of the limb its w^hole length, and has 
feveral names given it from the feveral places thro* 
which it paffes. 

The arteries have three coats; a middle muf- 
Gular, and an external and internal membranous.. 
The veins are faid to have the fame ; the internal 
coat of an artery may be pretty eafily feparated, but 
not the external ; and though the veins have muf- 
€u!ar fibres, yet I could never feparate any one di- 
Aindly into three coats ; and in. the infide of the 
veins there are many valves, efpecially in the low- 
er limbs, to hinder any reflux of the venal blood, 
which otherwife would have happened from the 
frequent adtions of the mufcles on the outfides of 
the veins -, and both the arteries and veins, as they 
run in the infide of the lim.b, or as they are dif- 
pcrfed in parts that fuifer great extenfions, as the 
iftomach, guts^ and uterus^ they are curved, fo 

much 



ARTERIES AND VEINS. 191 
much as that when thefe parts come to be diftend- 
ed, they may comply with thofe diftentions by on- 
ly being flreightened, and fo preferved from being 
flretched, which would leffen their diameters. The 
fmall arteries near the heart go off from the large 
trunks at obtufe angles, farther at lefs obtufe angles, 
then at right angles, farther ftiil at acute angles, 
and near the extren:iities at very acute angles, be- 
caufe the blood in the veffels far from the heart 
moving with lefs velocity than the blood in the 
veffels near the heart, the blood in the collateral 
branches more remote from the heaXt wants the ad- 
vantage of a direder courfe ; and becaufe a very 
large branch arifing out of another, might weaken 
too much the (ides of the veffel it w^ould arife from, 
that inconvenience is prevented by increafing the 
number, and fo leffening the fize of the collateral 
branches, where otherwife one large branch would 
have ferved better 5 as in the going off of the fub- 
clavian and carotid arteries, which might have gone 
off for fome fpace in one trunk -, but this mecha- 
nifm is more evident in the going off of the arteria 
coeliaca and mefenterica fuperior. And the fmali 
arteries always divide fo as that the leffer branch 
may lie leaft in the direction of the blood flowing 
into them, which makes the blood flow moff free- 
ly into that branch that hath fartheil to carry it^ 
and the fmaller branches arife more of- lefs oblique- 
ly from the fides of other arteries, according to the 
proportion they bear to the arteries they arife from, 

N 2 becaufe 



196 ARTERIES AND VEINS. 

becaufe an artery comparatively large ariiing ob- 
liquely from the fide of another, would make an 
orifice in that it arifes from too large, and weaken 
it. And both thefe ends are at once brought about, 
by making the arteries, that give off the branches, 
bend more or lefs towards the branches they give off, 
according to the comparative magnitude of the 
branches given off. 

BoRELLi has computed the force which the 
heart exerts at every fyftole, to be equal to three 
thoufand pounds weight, and the force which all 
the arteries exert at every fyftole, to be equal to 
fixteen thoufand pounds weight, and that they to- 
gether overcome a force equal to an hundred and 
thirty fix thoufand pounds weight -, and Dr. Keii. 
has computed that the heart in every fyftole exerts 
a force not exceeding eight ounces. The firft com- 
putation was made by comparing the heart with 
other mufcles, whofe power to fuftain a weight could 
be beft determined •, and the latter was made from 
ti>e velocity of the blood moving in an artery : 
Therefore if we confider that Borelli's way of 
computing led him to find out the abfolute force 
of the heart, and Dr. Keil's the force which the 
beitrtufaally exerts, perhaps thefe very different com- 
putations may be accounted for • for if the force of 
the heart, which is conftantly exerted, (hould, com- 
pared with any other mufcle, be but in a reciprocal 
proportion to the frequency of their aftions, and 
the Importance of their ufes; may not the heart 

very 



ARTERIES AND VEINS. 197 

very fitly have a force vaftly greater than ufually it 
«xerts, becaufe it is always in adion, and muft be 
able to exert a certain force in the lowed ftate of 
health ? What force the heart ever exerts in a grown 
man, I cannot fay ; but it muft be lefs in each ven- 
tricle than is fufficient to burft the valves, which 
hinder the blood from returning into the auricles out 
of the ventricles, or than is fufficient to break thofe 
threads by which thefe valves are tied to the papillae. 
In a dog I found the force which the heart would ex- 
ert, would not raife to one foot perpendicular heighth 
a column of blood through the aorta afcendens. 
And when I injedl the arteries of a child, I find a 
force exceeding little will throw water through 
all the veflcls, with a velocity equal to that with 
which the blood moves in thofe veffels when living. 
And if the heart, like other mufcles, can perform 
the firft part of its contradion v/ith moft eafe, is 
not the quick adions of the heart in hedic fevers 
owing to its not being able to empty the ventricles 
every fyftole, which, I think, will oblige it to ad, 
caeteris paribus, fo much the oftener ? For the fol- 
lowing ingenious attempt to account for the fyftole 
and diaftole of the heart, and the reciprocal adiong 
of the auricles and ventricles, I am obliged to 
Mr. Monro. 

" PosTULATA, that the adion of the mufcles 
*« depends oh the inf-ux of blood and liquidum 
[^ nervofum into the mufcular fibres, and therefore, 

N 3 *^ v/henever 



198 ARTERIES AND VEIN-S. 

<^ whenever the mufcies are deprived of either or 

" both thefe fluids, their adicn ceafes; this a great 

^- many authors, have fully proved by tying and 

^^ cutting the nerves or arteries that ferve any muf- 

^^ cle. That all mufcies are in a conftant ftate of 

^' contradion as long as the blood and liquidum 

*^ nervofum are freely fupplied to them, which 

*^ feems evident from the fphinder ani and veficse, 

^' and from the continued contraftion of fuch muf- 

" cles, whofe antagonifls are cut afunder, or pa- 

^^ ralytic. That the nerves of the heart run to it 

*' between the auricles and arteries, and that the 

*' arteris coronaris rife from the aorta behind the 

** valvulae femilunares, both which are evident from 

^^ diiiedions. If then both auricles and ventricles 

*^ are ready, upon the firft com.munication of mo- 

^' tioDj to ccntradtat the fame time, the ventricles, 

*' as Dr. Keil well obferves, being ftronger will 

^' firft contrad, and hinder the contradion of the 

*^ auricles, which muft be in the mean time much 

^' dilated hy the influx of blood from the veins, 

«^ while the arteries are alfo dif tended by the blood 

^^ thrown out of the ventricles ; therefore the car- 

*^ diac nerves lying between the two will be com- 

^' preiied, and the courfe of the liquids in them flop- 

*' ped ^ at the fame time the blood that rufhes out 

^' of the left ventricle into the aorta, pufhes the 

?^ valves of that artery upon the orifices of the ar- 

^' teri^ cQronari^3 fo that no blood can enter into 

' - thf 



ARTERIES AND VEINS. 199 

«« the fubftance of the heart : Thus both caufes of 
^ contradion failing, this mufcle muft become pa- 
^' ralytic. The refiflarxce then to the contradion of 
** the auricles being now removed, they will throw 
** their blood into the ventricles ; and the impulfion 
*^ of blood into the arteries from the heart now alfo 
** ceaiing, the two great arteries will be conftrid:- 
^' ed : The nerves are therefore now again free from 
*^ compreffion, and the valves of the aorta being 
" thruft back upon the mouth of the ventricle, the 
*^ blood enters the arterias coronariae ; fince the ven- 
" tricles are again fupplied with both the liquids, 
" on which their contraction depends, they muft 
*' again aft. And thus as long as thefe caufes con- 
*' tinue, their efFeds muft follow, i. e, as long as 
*^ the creature lives, the heart muft have an alternate 
*' fyftole and diaftole, and the auricles and ventricles 
*' have reciprocal adions/' 

If the arteries contrad fuppofe a fourth part of 
the fquares of their diameters at every fyftole, and 
if the heart does not throw out a quantity at every 
fyftole, equal to the fourth part of the folid con- 
tents of all the arteries when dilated, it is evident 
the heart does not throw the blood through the 
whole arterial fyftem, but into fo much of the ar- 
teries neareft the heart, as will contain four times 
as much as is thrown out of the left ventricle at 
once ; and then this portion of arteries throws the 
blood forwards and dilates the arteries that lie aexr, . 

N 4 and 



^00 ARTERIES AND VEINS. 

and fo on : But if the capacities of all the arteries 
taken together in their utmoft dilatations, exceed 
their capacities in their utmoft contractions, juft fo 
much as the quantity of blood amounts to, which 
is thrown out of the left ventricle of the heart at 
every fyftole, which I believe is the cafe, then eve- 
ry contraftion of the heart propels the blood through 
|:he whole arterial fyftem, which may be the reafon 
why the largeft animals, caeteris paribus, have the 
flowefl pulfjs and leaft vigour in their motions, and 
perhaps too for the fame reafon require a lefs pro- 
portion of food. The fedlions of all the remoter 
veffels being greater than a feftion of the aorta, 
the blood will move fo mu ch flower in the lef- 
fer veffels than in the greater, as the fedlions 
ofthelefler veffels taken together, exceed the fec- 
tion of the greater veffel or veffels. The ftrength 
of the coats of the arteries, if the blood preffed 
equally againil: the fides of then) all, ceteris pari- 
bus, ought to be one to another as their circum- 
ferences, becaufe fo much as the circumference of 
one artery is greater than another, fo much greater 
preffure its fides muff fuftain ; but the arteries 
Beared the heart, fuftaining the re«aftion of all the 
arterial blood, they muft have a ftrength yet great- 
er than in that proportiqn : And the veffels, both 
arteries and veins, the more diftant they are from 
the head, the greater proportional ftrength their 
pDat? muft have^ becaufe the arterial and venal blood 

^ommu? 



ARTERIES AND VEINS, scj 

communicating, they will prefs upon the lower 
veffels, with a force proportional to the perpendrcu- 
iar altitude of blood above, which will be that of 
the perpendicular altitude of the whole body 5 for 
though the afcending blood of the arteries may be 
faid not to prefs upon the defcending, becaufe it 
moves another way, neverthelefs it being thrown 
from the heart into one common veffel, which af- 
terwards divides, the blood moving both ways com- 
municates^ and that force which is neceflary to 
overcome the natural inclination of the afcending 
blood to defcend, will be imprefled alfo upon the 
defcending blood, which is juft the fame with the 
weight of the afcending blood j and the veins both 
from above and below communicating at the right 
auricle, the preffure in them will alfo be as the 
perpendicular altitude of the body. So that the 
blood in all the veins and arteries may be compared 
to a fluid in a curved tube, in \yhich that part in 
one leg exaftly balances that in the ether, and both 
preffing moft upon thofe parts which are neareft 
the centre of the earth. Accordingly we find by 
jExperience, that humours are mofl apt to flow to 
the lowefi: parts, and that by laying thofe parts upon 
a level with the whole body, this inconvenience is 
remedied ; but laying a leg only on a chair does it 
but in part, juft fo much as the perpendicular alti- 
tude of the body from that part is fhortened. There 
is alfo to be confidered concerning the thicknefs of 
$1)9 coats of the yeffels^ that the blood moving flower 



202 ARTERIES AND VEINS. 
in the fmall veffels than in the great, the moment 
of the blood againft the fides of a fmall veflel will 
be as much lefs than the moment of the blood 
againft equal parts of a great one, as the velocity of 
the blood in a fmall vefiel is lefs than that in a great 
one ; and therefore their coats may alfo differ from 
the former proportion, as the velocity of the blood 
differs. Moft of the fmall vefTels in the limbs ly- 
ing againft one another are a mutual fupport, and 
therefore lefs liable to be dilated or bur ft than ca- 
pillaries v^hich lie in the thin membranes of cavi- 
ties, fuch as in the nofe. Hence thefe, I fuppofe, 
are moft fubjed: to hemorrhages. And if hemor- 
rhages of blood do frequently arife from obftrudtions 
in the minuteft veffels, does it not appear how 
opium and the bark, if they thin the blood inward- 
ly taken (as they do moft pov/erfully when mixed 
with it) come to be fo often effedual remedies in 
that cafe ? And the coats of the lefTer veffels bsing 
proportionably weaker than the great ones, accord- 
ing to the decreafe of the velocity of the blood, 
which leffens the moment with which it moves in 
them, whenever the blood begins to move in them 
with an equal velocity, or greater, as it happens 
after an amputation, when the larger veffels are tyed^ 
the force of the blood fometimes overcomes the 
ftrength of the coats of the fmaller veffels, and di- 
lates them fo, that thofe veffels, which fcarce bled 
during the operation, will fom.etimes bleed after- 
wards. And this conftant effort of the blood to 

dilate 



ARTERIES AND VEINS. 203 

dilate veflels upon the cbftrudlioRS of others may 
caufe thofe throbbing pains which are felt in wounds 
when the bleeding is flopped, and in all violent in- 
flammations, until the collateral branches are dilated^ 
or the tenfion of the parts otherwife taken off. 

The extreme branches both of the arteries and 
veins Jiave very numerous communications, like 
thofe in the ftamina of the leaves of plants, by 
which communications the blood that is obfl;ru(5ted 
in any veffels may pafs off by other veflels that are 
not obftruded; and the moment of the blood in the 
veffels leffening, and the fri<flion from the veffels 
increafing as it approaches the extremities ; and as 
many of the leffer veffels are more expofed to pref-^ 
fure than any of the large ones, thofe communica- 
tions in the leffer veffels are therefore made more 
numerous. By means of thefe communications, 
the blood circulates in a limib that has had part am- 
putated, and into any veffels that have be€n fepa- 
rated from the trunks that fupplied them, which 
otherwife muft have mortified for want of nourilh- 
naent, and with them, for the fame reafon, all the 
branches that arife from fuch feparated veffels 5 and 
I can difcern no other way than by thefe commu- 
nications, that the fluids contained in a large inflamr 
mation can fuppurate into one cavity. 

If we injed by the arteries a large quantity of 
a coloured fluid, we find all the large veins full of 
that liquor before aiiy of the folid parts are much 
coloured with it ; and upon frequent repetitions all 



2G4 ARTERIES AND VEINS. 
of them much lefs coloured than, I think, might be 
expefted, if it had gone into all the velTels of the 
body; and I have often thrown wax or tallow 
coloured with vermilion or verdigreafe, through 
all the arteries, and back again through the 
veins, even to the heart, every v/here filling veffels 
that cannot be difcerned without a microfcope 5 and 
-all this without filling or much difcolouring any one 
entire part. In viewing with a microfcope the cir^ 
culation of the blood in the tail of a fifli, the eye 
eafily traces arteries to their extremities, and their 
return in veins ^ yet all the veffels we can fee make 
but a fmall part of the whole of what we fee ; 
though we are taught that the whole animal body 
is a compages of veffels, fuch as we fee : But if it 
were fo, I think, we could not wd\ diftinguifh any ^ 
and if the fum of the diameters of all the veffels 
we can fee, are to that of the breadths and thick- 
neffes of all the reft of the parts, which we fee at 
the fame time, taken together, but as one to five, 
ihefe veflels then are no more than the twenty 
^fth part of what we fee with them. What then 
j(hajl we fupppfe the reft of the tail, and thofe parts 
which were (o little tinged, and thofe which wer^ 
not filled with wax, in the foregoing experiments, 
compofed of? Are they not compofed of veffels 
which arife from the arteries, as excretory duds 
do in a gland, but terminate in the veins ? And thefe 
veffels being only to convey the nutritious juices, 
^nd what elfe may be a proper vehicle for thepi. 



ARTERIES AND VEINS, 2o| 
is it not fit the circulation in them (hould be ex- 
ceeding flow, that the nutritious particles may ad- 
here the eafier to the fibres of the veflels, which 
they are to augment or repair ? Befides, if any 
whole part was made up of blood-veffels, or any 
other veflels with fluids moving fwifdy in them, it 
feems to me Impofljble, that one part of a limb can 
be very cold while another part is hot, if the warmth 
of the parts is owing to the fluids they contain. 
And if there are fuch veflfels as thefe, the velocity 
of the motion of their fluids will not depend upon 
any proportion they bear to the veflTels they arife 
from, but upon the velocity with which their fluids 
are feparated from the arteries into them, and the 
proportion of the fedions of all their orifices to the 
fum of their own feftions, at any diftance where 
we would compare the velocity of their fluids. And 
the fl:rength of the coats of thefe veflfels may not 
only be as much lefs than the fl:rength of the coats 
of an artery, as their diameters are lefs, but alfo 
lefs in that proportion in which the velocity of their 
fluids is lefs, and the motions more uniform, than 
the velocity and motion of the blood in an artery. 

The coats of the veins are much thinner than 
thofe of the arteries, comparing veflils whofe fec- 
tions are equal, becaufe the blood moving flower 
in the veins than in the arteries, it preflTes with lefs 
moment againfl: their fides : And befides, the blood 
in the veins has nearly an equal uniform motion, 
but in the arteries a very unequal one 3 and that 

will 



^a6 ARTERIES AND VEINS. 
will require a farther difference in the ftrength of 
their coats ^ for thofe of the arteries muft be equal 
to the greateft natural prefTure -, and if the arterial 
blood propels the venal, that is a farther reafon for 
the different llrength of their coats. 

All thefe things being confidered, it appears to 
be a difficult thing to determine nearly, what pro- 
portion the fluids of an animal body bear to the 
foIid&, or what proportion the fum of all the mi- 
nutefl arteries bear to the aorta, without which I 
think we can neither determine the comparative ve- 
locity of the blood moving in the different velfels, 
nor the quantity of blood in any animal body, nor 
the time in which the whole mafs of blood, or a 
quantity equal to the whole mafs, is flowing thro' 
the heart. But if each ventricle of the heart holds 
five ounces of blood, and they are filled and emp- 
tied every fyf!:ole and diaftole, which I think is 
true, and if eighty piilfes in a minute be allowed 
to be a common number, there then flows twenty 
five pounds of blood through each ventricle of the 
heart in a minute. Dr. Keil has (hewn that the 
fum of all the fluids in a man exceed the fum of 
all the folids, and yet the quantity of blood which 
all the vifible arteries of a man will contain, is lefs 
than four pounds ; and if v/e may fuppofe all the 
vilible veins, including the vena ports, hold four 
times as much, the whole then that the vifible vef- 
fels can contain is not twenty pounds 3 but the v/hole 
that they do contain is but very little m^ore than th@ 
3 veins 



ARTERIES AND VEINS. 207 
yeins can contain, feeing ths arteries are always 
found almofl: empty in dead bodies j but how much 
the invifible arteries and. veins contain, Imeantnofe 
which contain fach a compound fluid as is found 
in the larger veffels, I know no way to judge, un- 
lefs we knew what proportion thefe veflels bear to 
thofe that carry the nutricious juices and ferum (if 
there are fuch) without the globuli of the blood. 
Ceteris paribus, is not the velocity of the blood in 
all animals proportionable to their quantity of 
adion; and their neceffity of food alfo in pro- 
portion to their quantity ofadion ? If fo, it appears 
how thofe animals which ufe no exercife, and whofe 
blood moves extremely flow in the winter, can fub- 
fifl: without any fre(h fupply of food, while others 
that ufe a little more exercife, require a little more 
food ; and thofe who ufe equal exercife winter and 
fummer, require equal quantities of food at all 
times, the end of eating and drinking being to re- 
pair what exercife and the motion of the blood has 
deftroyed or made ufelefs ; and is not the lefs ve- 
locity of the blood in fome animals than in others^, 
the reafon why wounds and bruifes in thofe animals 
do not fo foon deftroy life, as they do in animals 
whofe blood m^oves fwifter ? 

I HAD a patient, whofe mufcles on the infide 
of the thigh were torn to pieces with the cramp, 
from whence was a vafi: effufion of biood among 
the mufcles. The tumor being opened, itv^asjudgeti 
necefliary to take off the limb. The patient, having 

a great 



^o§ ARTERIES AND VEtf^i. 

a great difcharge from flie wound, was eafy for 
about ten days 3 but the cramp then returned into 
the ftump with fuch exceffive torment that he died 
foon after. I have never heard but of one other 
cafe of this kind, which ended in the fame man- 
ner. 

When any of the Veffels are lacerated by bruifes, 
fti'ains, or otherwife, without any external wound, 
purging (which is of more ufe than one can well 
account for) and cooling applications are always 
proper to prevent as much as may be extravafations 
of blood or ferum ^ but the lacerations once healed, 
which may be in eight or ten days, and the pain 
quite gone, then warm medicines may be applied, 
with opium, or fp. cornu cervi (which powerfully 
feparate coagulated fluids) to help to attenuate and 
thereby diffipate the extravafated juices. 

When the blood- veffels become unable to pre- 
fervc the circulation in the extreme parts, whether 
from particular weaknefs in the veffels, or any 
other decay, I have always obferved it to be hurtful 
to fcarify. It lets out the juices that fhould affift 
nature to make a feparation of the mortified part 5 
nor can it be known in what place we may fafely 
amputate till fuch a feparation, which teaches ug 
where it can be fupported, and in any place fhort 
of that an operation will be both ufelefs and mif- 
chievous. I have known many fucceed well who 
have been thus left to feparate, but very few that 
were otherwife treated 5 nay, have known fome 

extra- 



LYMPH^DUCTS. ^209 
extraordinary inftances of fuccefs where the patient 
had the happinefs to have no one about them to 
interrupt the kind affifiance of nature. 



CHAPTER X. 

Of the lymphcedu6is, 

LYMPH^DUCTS are fmall pellucid cylindri- 
cal tubes which arife invilible from the extre- 
mities of the arteries throughout the whole 
body, but more plentifully in glands than o:her parts, 
and in greated: number from fuch glands as feparate 
the vifcideft fluids, as may be obferved in the liver 
and teftes. They cannot be difcerned in a natural 
ftate to have more than one coat, and that exceed- 
ing thin, having valves at fmall and uncertain di- 
ftances, to prevent the regrefs of their fluid. They 
have frequent communications like the veins, but 
do not unite fo often \ the larger trunks are in ma- 
ny places attended with fmall glands, thro' which 
they run, and at the fame time fend communicant 
branches over them, that they might be fecured 
againil: obftrudions from dlfeafes in ihofe glands. 
They all terminate in the vafa ladea, or in the large 
veins. All that rife in the abdomen empty into the 
venae ladteae fecundi generis and receptaculum chyli ; 
thofe in the cavity of the thorax into the dudus 
thoracicus and the fubclavian veins. Their ufes arc 

O to 



210 L Y M PH ^ D U G T S; - 
to carry lymph to dilute the chyle, to make it in- 
corporate more readily with the blood (but not to 
make it flow the better in the ladleals, as appears 
fnfficientiy from their not entering into the minut- 
qA laSeals) and to carry off fo much lymph as is 
neceffary to leave the blood in fit temper to flow 
through the veins ; for it is always obferved that in 
fuch perfons as have their blood too thin, the glo- 
buli cohere and form moleculae, or polypufes, 
which I imagine may arife from the globuli of the 
blood not rubbing often enough, and with fufficient 
force one againft another to difunite them as fafl 
as they cohere. Thefe polypufes are frequently 
found in all the large veins, and in the right auricle 
and ventricle of the heart, efpecially in fuch bodies 
as die hydropic or of any chronic difeafes. 

Authors have defcribed and painted thefc 
veflels as they appear when injedled with mercury ; 
in which cafe the coat of thefe veffels being exceed- 
ing thin, it is not able any where between the valves 
to reiift the mercury's attrading itfelf into globules : 
And the fame appearance alfo happens when they 
are vaftly diflended; becaufe the valves hindering 
a diflention where they are featcd, the fpaces be- 
tween them approach to a fpherical figure from the 
equal preffure of the fluid, according to the degree 
of their diftention : but in a natural flate when 
they are filled with lymph, or when they are mo- 
derately injefted with air or water, they appear as 
cylindrical as the veins. Any of thefe veflels being 

buril. 



L Y M P H .« D U C T S. 211 

fctirft, they caufe a dropfy in the cavity into which 
they open, which is oftener in the abdomen than the 
thorax. This kind of dropfy is fometimes cured by 
tapping, and I believe the reafon why it no oftener 
fucceeds is, that it generally takes its rife from a 
difeafed liver. Formerly in this operation only part of 
the water was drawn oiTat a time, and the tap fome- 
times left in the wound to draw off more, which 
was exceeding painful, and fometimes brought on 
a mortification 5 and if they drew off much water 
at one time the patient was in great pain, and ge- 
nerally fainted, which was thought to proceed from 
the lofs of too much of the liquor at once. But 
Dr. Mead obferving that thefe fymptoms could not 
proceed from the lofs of an extravafated fluid, foon 
foiind the true caufe, which was the fudden want 
of the prefTure of the abdominal mufcles again ft 
the parts contained in the abdomen ; and in the 
year 1705, being then phyfician to St. Thomas's 
hofpital, ordered it to be tried there in the follow- 
fiig manner : He direfted the abdomen to be prei? 
fed by the hands of alTiftants while the water was 
running out, and afterwards kept rolled till the 
mufcles recovered force to do their office, and fo 
took out all the water at once without any inconve- 
nience, which has made this operation not very 
painful, fometimes fuccefsfui, and never danger- 
ous. I preferved one woman, by fixteen opera- 
tions, from the fifty fixth year of her age to eigh- 
ty s another 'fix years by fixty fjx tappings : It 

O 2 mud 



512 LYMPHATIC GLANDS. 

muft be confeffed that fcv/ cafes fucceed like thefe, 
and very few recover. 

I OPENED a v/oraan who died of a dropfy \n 
the liver, in which I found the gibbous part entire- 
ly wafted, and the coat of the liver about a quarV 
ter of an inch thick, which contained about fivQ 
gallons of a grofs yellowifli fluid, in which were 
many hydatids about the fize of goofe-berries, and 
fome pieces of matter of as bright a red as ver- 
milion. At about fourteen years of age flie firft 
began to feel pain in this part, which returned 
monthly, but in time grew continual, her belly 
conftantly encreafing till llie died, which was in the 
twenty eighth year of her age, without ever having 
had her menfes. All the other vifcera both in the 
thorax and abdomen v/ere perfedly found, nor was 
there the leafl fign of the dropfy in any of the 
lim.bs, or yellownefs in the Ikin, which is frequent 
in difeafes of the liver. 



CHAPTER XL 

Of' the lymphatic glaiids. 

TH E glands accompanying the lymphatics 
are fituated in the three cavities, in the in- 
terftices of the mufcles, where the lymphatics lie 
with the large blood- veilels, and in the four emun- 
d;ories, viz. the arm-pits and groins. In the brain 

is 



LYMPHATIC GLANDS. 213 

IS feated the glandula pinealis, which I judge to be 
of this fort, having often feen large lymphsduds. 
running into it from the plexus choroides -, and at 
the balls of the brain in the fella turcica is the glan- 
dula pituitaria, into which enters a large lymphatic, 
as I imagine^ named infundibuliim (vid. chap. Of 
the brain.) In the neck are fituated a great many 
of thefe by the fides of the carotid arteries and in- 
ternal jugular veins, and two, or a fort of double 
one, upon the larynx immediately below the thy- 
roid cartilage, from which fituatlon they derive the 
name of thyroides ; and jufl: v/ithin the thorax is 
feated another, called thymus. In very young chil- 
dren the thymus is as large, or larger than the thy- 
roid glands ; but in men thefe glands are very large, 
and the thymus very fmall, the former having en- 
creafed in about a double proportion of any other 
gland of this kind, and the latter having rather di- 
miniflied than encreafed : But in brutes, fuch as 
have fallen under my obfervation, it is juft con- 
trary. From v^hich obi^rvations I am inclined to 
conclude, that they both belong to the very fame 
lymphatics, and that either of them encrea/ing as 
much as both ought to do if both encreafed, an. 
fwers the fame end as if both did ; and that the 
reafon why the thymjjs encreafes rather than the 
thyroid glands in brutes, is becaufe the fliape of 
their thorax affords convenient room for it to ledge 
in ', and that in men the thyroid glands encrealcd 
fo much becaufe there is no room in that part of 

O 3 the 



214 LYMPHATIC GLANDS. 

the thorax where the thymus is feated for a large 
gland to be lodged. In dogs, a porpufs, and fome 
other animals, I have feen the lymphatics in the 
thymus and between the thymus and dudus tho- 
racicus full of chyle, and fo in many other lyrn- 
phatics near the yafa ladea. Under the bafis of the 
heart, and at the fides of the lungs, where the great 
veffds enter J are many of thefe glands, from the fize 
of a pea to that of a hazel nut. In the abdomen 
upon the loins near the kidneys, and by the fides of 
the iliac veffels are many of thefe glands, which are 
called lumbales^ and there are fome at the hollow 
fide of the liver, named hepatic^: The r^iefentery 
alfo is full of glands of a like appearance, but thefe 
feem to belong only to the ladeal veips^^ unlefs fome 
of them^ which are feated at the bafis of the me- 
fentery among the vens ladeae fecundi generis, 
belong to the lymphatics that come from the liver^ 
where the hepatic lyrpphatics pafs in their way to 
the receptaculum chyli. The glands which accom- 
pany the blood-veffels in the limbs are few, and 
diftributed in no certain order 5 except thofe in the 
four emundories, i. e. in the armpits and groing, 
iiamed axillaris and inguinales. 

Brutes have one large one in the thigh, com- 
monly called the popeVeye ; this is feated about 
the great veffels in the thigh, where they pafs 
through the triceps mufcle. From this fitua- 
tion, and not from any thing extraordinary m this 
'gland^ it is that wounds are there fo dangerous. 
4 The 



LYMPHATIC GLANDS. 215 

The lymphatic glands are faid by Nuck, and 
others after him, to be compofed of veiicles^ and 
not of veflels like other glands ; and that thefe ve- 
ficles are repofitories of lymph: But from their 
appearance in a natural ftate, which is very corn- 
pad and uniform, there feems to me to be but lit- 
tle reafon for fuch a conjedure. Some have thought 
their ufe to be by contracting to accelerate the mo- 
tion of the fluid in the lymphatics ; but that does 
not feem very probable, becaufe a mufcular coat 
w^ould have been the readieft means to produce that 
efFedl; befides, thefe veffels feldom enter any of 
them v^ithout detaching a branch over at the fame 
time perhaps to prevent obflrudlions. And if thefe 
glands were endued with a contrading power, which 
is only prefumed without any proof, it would ftill 
be difficult to conceive how fuch a power, applied 
at uncertain fpaces, fhould not rather obftrud than 
accelerate the motion of lymph in the lymphatics, 
unlefs there were valves to prevent a reflux ; and 
even then, if this were a convenient piece of me- 
chanifm, it would be ftrange it fliould no where 
elfe in the body be made ufe of. 

These lymphatic glands being difeafed, are 
apt to obftrud and occafion the burfting of the lym- 
phatics that pafs through them ; which, if in the 
bread:, caufes an incurable hydrops pedoris; if in 
the abdomen, the true afcites, attended with a waft- 
ing of the limbs, Vvdiich is never cured, but may 
be relieved by tapping. 

O4 CHAPTER 



2i6 COURSE OF THE 

CHAPTER XII. 

0/ the courfe of the aliment and fuids^ ahJlraBed 
from the foregoing chapters, 

TH E aliment being received into the mouth, 
is there mafticated, and impregnated with 
faiiva, which is prefled oat of the ialivary glands 
by the motions of the jav/ and the mufcles that 
move it and the tongue. Then it defcends through 
the pharynx into the ftomach, where it is digefted 
by the juices of the ftomach (which are what is 
thrown out of the glands of its inmoft coat, and 
faiiva out of the mouth) and a moderate warmth 
and attrition. Then it is thrown through the py- 
lorus or right orifice of the ftomach into the duo- 
denum, w^here it is mixed v^ith bile from the gall- 
bladder and liver, and the pancreatic juice from 
the pancreatic gland. Thefe fluids ferve further to 
attenuate and dilute the digefled aliment, and pro- 
bably, to make the fluid part feparate better from 
the faeces. After this it is continually m.oved by 
the periftaltic motion of the guts, and the com- 
preffion of the diaphragm and abdominal mufcles, 
by Vv^hich forces the fluid parts are prefied into the 
ladeals, and the grofs parts through the guts to the 
anus. 

The chyle, or thin and milky part of the ali- 
mentj being received into the lacSe^ls from all the 

fmall 



ALIMENT AND FLUIDS. 217 

fmall guts, they carry it into the receptaculum chy- 
li, and from thence the dudus thoracicus carries it 
into the left fubclavian vein, where it mixes with 
the blood, and paffes with it to the heart. 

Al l the veins being emptied into two branches, 
viz. the afcending and defcending cava, they emp- 
ty into the right auricle of the heart; the right 
auricle unloads into the right ventricle, which throws 
the blood through the pulmonary artery into the 
lungs ; from the lungs the blood is brought by the 
pulmonary veins into the left auricle, and from 
that into the left ventricle, by which it is thrown 
into the aorta, and diftributed through the body. 
From the extremities of the arteries arife the veins 
and lymphatics ; the veins to colled: the blood and 
bring it back to the heart ; and the lymphatics to re- 
turn the lymph, or thinner part of the blood, from 
the arteries to the veins and the vafa ladea, where 
it mixes with the chyle, and then paffes with it in- 
to the left fubclavian vein and to the heart. 

All the fluids that pafs into the ftomach and 
guts being carried into the blood-veffels, the great- 
eft part of them are feparated and carried off by 
proper veffels, viz. urine from the kidneys, bile 
from the liver, &c. and thefe juices carry along 
with them whatever might be injurious to the 
animal oeconomy. 



CHAPTER 



Zi^ D U R A M A T E R. ^ 

CHAPTER XIII. 

Of the dura mater and fia mater, 

DURA MATER is a very compaft ftrong 
membrane lining the infide of the fcull^ 
firmly adhering at its bafis^ and but lightly 
at the upper part, except at the futures. It has 
three proceffes 5 the firft, named falx, begins at the 
criila gain, and runs backwards under the futura 
fagltalis to the cerebellum^ dividing the cerebrum 
into tw^o hemifpheres. Its ufe is faid to be to fup- 
port one fide of the cerebrum from preffing on the 
other when the head is inclined to one fide. But 
\ think it is evident that this is not the ufe, becaufe 
there would he more need of fuch a procefs from 
one fide of the fcuil to the other, than this way; 
and it would alfo be very neceffary that it fhouid 
run through the brain, to anfwer that end. The 
principal ufe appears to me to be to divide the braia 
into fuch portions as are leaft liable to be moved 
in the fcuU by any violent motions of the head^ 
which is better done this way than it would the 
other ; and the under-fide of the brain is kept fted^ 
dy by the inequalities of the bafis of the fcuH, 
which the brain is exadly fitted to. In brutes the 
fclx is always very final], therefore in thofe whole 
brains are of the larger fize, as oxen, flieep, horfes, 
&c. the upper part of the fcuU is made uneven, 
txadlly to fit the folds of the brain, which fecures 

the 



D U R A M AT E R. 219 

the upper parts of their brains from concuflions, in 
the fame manner that the lower parts are fecurecj. 
The fecond pi-ocefs runs from the lower and back part 
of the former to the upper edge of each os petro- 
fum, and fuftains the poflerior lobes of the cere- 
brum, that they might not comprefs the cerebellum. 
Jn fuch rapacious ^nimals as I have differed, this 
procefs is bone. The third is very fmall 5 it runs 
from the laft defcribed procefs down towards the 
great foramen of the fcull, and poffefles the fmall 
fpace in the cerebellum, between the proceiTus ver- 
miformis. Thefe proceffes of the dura mater alfa 
ferve to keep the brain fleddy. 

The dura mater has in it feveral finufes, which 
are large veins to receive the blood from the leffer 
veins of the brain : Their number is uncertain, 
and thofe that are conflant are not defcribed in the 
^ame order by writers. The firft that prefents it- 
felf is the longitudinal is fuperior, running from a 
blind hole a little above the crifta galli all along 
the upper edge of the falx. A tranfverfe fedlion 
of this veffel is not circular, like other vellels, but 
a triangle whofe fides are arches of a circle ; the 
upper fide convex outwards, and the two lower 
convex inwards. The figure of this vefl!el is pre- 
ferved by fmall ligaments running acrofs in the in- 
fide, that it might not become conical, or cylindri- 
cal, like other veflels, from the equal prefilire of 
the contained bloody and thereby incommode the 

upper 



t^20 DURA MATER. 

the upper edges of each hemifphere of the cerebrum. 
On the lower edge of this procefs is generally an- 
other very fmall one, called longitudinalis inferior ; 
this runs into the redus^ and when wanting is 
fuppiied by a vein 5 redtus runs between the two 
foil procelTes of the dura mater, and unloads with 
the finus longitudinalis fuperior into the two lateral 
linufes^ but for the moft part the longitudinal fi- 
nus goes more diredly into one of the lateral fi- 
nufes, and the ftrait finus into the other. There 
is fometimes a fmall one in the third procefs, which 
empties in the fame place with the former. From 
the endings of the longitudinal and firait finufes, 
begin the two lateral finufes, which, when they 
come to the os petrofum, dip down and pafs thro' 
the eighth foramina into the internal jugular veins. 
There is another named circularis, it runs round 
the fore part only of the fella turcica 5 the two 
ends of this empty into four finufes, one on the 
top of each os petrofum, which pafs into the finus 
laterales, and one at the under fides of the fame 
bones, which pafs indifferently into both the late- 
ral and cervical finufes 5 thefe two lafl finufes have 
always communicant branches. The cervical fi- 
nufes run from the bafis of the fcull through the 
great foramen on both fides of the medulla fpina- 
lis collij and through the tranfverfe procefles of the 
cervical vertebra 3 the lafi: of thefe have many times 
proper foramina running from the eighth foramina 

/ . 



P I A M A T E R. 22 1 

to the back part of the apophyfes of the occipital 
bone. There are alfo two more of thefe veflels, 
which run from the circular finus between the os 
fphenoides and fore part of the os petrofum diredt- 
ly into the internal jugular veins. 

PiA MATER is an exceeding fine membrane 
immediately inverting the brain even between its 
lobes, hemifpheres, and folds. It ferves to contain 
the brain, and fupport its blood- vefTels, which run 
here in great numbers, for the arteries to divide in- 
to fmall branches upon, that the blood may not 
enter the brain too impetuoufly ; and for the veins 
to unite on, that they may enter the finufes in 
fewer and larger branches. Between the dura and 
pia mater, is defcribed by feveral anatomifls, a 
membrane called arachnoides, which may eaiily be 
fhewn at the back part of the cerebrum, upon 
the cerebellum and back part of the medulla fpi- 
nalis. ^?cme* 

I HAVE fecn a large part of the dura mater, 
and once part of the pia m.ater offified. 



CHAPTER 



tli CEREBRUI^. 

i 

CHAPTER XIV. 

Oj the cerebrum^ cerebellum^ medulla oblongatd^ 
and medulla fpinalis^ 

dT^ EREBRUMis that part of the brain Virhich 
\^ pofleiTes ail the upper and fore part of the 
cranium, being feparated from the cerebel-* 
lum by the fecond procefs of the dura mater. Its 
upper fide is divided into two hemifpheres, and its 
lower fide into four lobes, two anterior and two 
pofterior, which latter are much the largeft. At 
the meeting of the four lobes appears the infundi^ 
bulum, which feems to be a lymphatic, running 
from the ventricles of the brain into the glandula 
pituitaria : This gland is feated in the fella turcica. 
Immediately behind the infundibulum appear two 
fmall bodies named protuberanti^. duas albse pone 
infundibulum. Between the two hemifpheres of 
the cerebrum, lower than the circumvolutions, 
appears a white body, named corpus callofuni. 
Under the corpus callofum appear the tw^o lateral or 
fuperior ventricles, which are divided into right 
and left by a very thin membrane named feptum 
lucidum, which is extended between the cor- 
pus callofum and fornix. The fornix is a me- 
dullary body, beginning from the fore part of thefe 
ventricles, with two fmall roots which foon unite 5 
and running towards the back part, where they 
divide into parts, called crura fornicis. In the ba- 

fis 



CEREBELLUM. 223 
fis of thefe two ventricles are four prominences : 
The two anterior ar^ called (from their inner tex- 
ture) corpora flriata; the other two are named 
thalami nervorum opticorum. Beyond thefe are 
two more procelTes, called nates ; and under them, 
nearer the cerebellum, two called tefles. Above 
the nates is fituated the glandula pinealis, famous 
for being fuppofed, by Des Cartes, the feat of 
the foul. And upon the thalami nervorum opti- 
corum are a number of blood-veffels, glands, and 
lymphaedudls, called plexus choroides. Under the 
beginning of the fornix is a fmall hole, called fo- 
ramen ad radices fornicis, or iter ad infundibulum ; 
and under the middle of the fornix, one called fo- 
ramen pofterius, which is covered with a valve 
named membrana, or valvula major 3 and the fpace 
under the two anterior ventricles between the fora- 
mina and the cerebellum is the third ventricle. 

Cerebellum is fituated under the fecond pro- 
cefs of the dura mater. By dividing this part of 
the brain length-v/ays we difcover more plainly the 
fourth ventricle, whofe extremity is called calamus 
fcriptorius ; here alfo appear two medullary bodies 
called pedunculi, which are the balis of the cere- 
bellum. Tne medullary part in the cerebellum, 
though it is inmoft, as in the cerebrum, yet is of 
a different fhape, being branched out like a plant. 

The fubflance of the brain is diftinguifhed in- 
to outer and inner : the former is called corticalis, 
cinerea, or glandulofa 3 the latter medullaris, alba, 
ornervea. Medulla 



224 MEDULLA OBLONGATA, &c. 

Medulla oblongata is a medullary con- 
tinuation of the under part of the cerebrum and 
cerebellum. It firft appears in tv/o bodies from the 
anterior part of the poderior lobes of the cerebrum, 
called crura medulls oblongata. The union of 
thefe crura between the cerebrum and cerebellum 
is called ifthmus ; and immediat-ely beyond this is 
an eminence named proceiiiis annularis. 

Medulla spinalis is a produdion of the 
medulla oblongata through the great foramen of 
the fcuU, and through the channel of the fpine : 
It enlarges about the laft vertebrae of the back and 
firft of the neck, where the large nerves are given 
off" to the arms ; it again enlarges in the loins, 
where the crural nerves begin 5 and the lower end 
of it, with thofe and other nerves, is called from 
its refemblance cauda equina. The coats of this 
part are the fame with thofe of the brain ; but the 
membrane here, which is analogous to the dura 
mater, is thinner and more connected to the bones, 
and the tunica arachnoides more conipicuous. 

Wounds in the cerebrum, though verv dan- 
gerous, are not m,ortal ; but in the cerebellum and 
medulla oblongata caufe fudden death ; and in the 
medulla fpinalis, lofs of fenfe in all the parts which 
receive nerves from below the w^ound. In perfcns 
that have died lethargic, I have always found the 
brain full of w^ater ; and in children the brain is 
always very foft and moiil:. In a man that died 
of an apoplexy. I found all the velTels of the brain 

immo- 



NERVES. if 5 

Immoderately diftended with blood, and the ven- 
tricles and the fubftance of the brain full of lymplj, 
the pia mater very much thickened, and ad- 
hering fo very clofely that the greateft part of it 
was feparated without breaking. 

I HAVE twice feen in the cerebrum a fcirrhous 
tumor as large as a pullet's egg -, and in another 
body, impofthumations which poffeffed near two 
thirds of the whole cerebrum. And in a perfoa 
that died with a gutta ferena, I found all the ven- 
tricles of the brain full of lymph ; and the thalami 
nervorum opticorum and the optic nerves, e'er they 
went out of the fcull, made fiat with the preiTure. 
And in an old man I found the right optic nerve 
wafted and black. 



CHAPTER XV. 
Of the nerves^ 

«« TJ^ROM the medullary part of the cerebrum^ 
X^ *' cerebellum, and medulla fpinalis, a vaft 
'^ number of fmall medullary white fibres 
^* are fent out, which, at their firft egrefs, feem 
*^ eafily to feparate, but as they pafs forward are 
" fomewhat more, but flill ioofely conneded, by 
«^ the coat which they obtain from the pia mater, 
" and at laft piercing the dura mater, are ftraitly ' 
" braced by that membrane which covers them in 

P "their 



cc 



€t 



226 NERVES. 

** their progrefs; whence they become white, firm,^ 
" flrong cords, and are fo, well known by the name 
«« of nerves. To thefe coats an infinite number of 
" veffels, both arteries and veins, are diftributed 5 
" fo that after a nice lucky injedion the whole cord 
" is tinged with the colour of the injedted liquor ^ 
*' but when the fibrils are examined, even with the 
beft microfcope,they appear only like fo many fmall 
' diftindt threads running parallel, without any ca- 
vity obfervable in them, though fome incautious 
" obfervers, miilaking the cut orifices of the arte- 
" rious and venous veffels, juft nov/ mentioned, for 
** nervous tubes, have affirmed their cavities to be 
" viiible. The nerves, which if all joined hardly 
«« make a cord of an inch diameter, would feem 
*' from their exerting themfelves every where, to 
** be diftributed to each, even the fnialleft part of 
*^ the body. In their courfe to the places for which 
*' they are deftined they generally run as ftrait as the 
" part over which they are to pafs, and their owa 
'^ fafety from external injuries will allow, fending 
*'^ off their branches at very acute angles, and con- 
*5 fequently running more parallel than the blood- 
*• veffels. Their diftribution is feldom different in 
*^ the oppofite fides of the fame fubjedt, nor in- 
*' d^ed in any two fubjeds is there confiderable va- 
^^ riety found. Frequently nerves which come out 
^^ diftindt or feparate, afterwards conjoin into one 
V fafciculus, under the fame common covering; 
'' and though the nervous fibrils probably do not 

*' ccmmu- 



NERVE S, Uj 

^'^ communicate (the reafon of which opinion fhall 
' immediately be given) yet becaufe the coats at 
^ the conjoined part are common, and thefe fcrong 
' coats may have great eiteds on the foft pulpy 
^ nerves, it is evident all fuch will have a conii- 
' derable fympathy with one another, whereof fe- 
' vera] examples in prad:ice fhall be inftanCed when 
^ the particular nerves are defcribed. In fome parts 
^ where there are fuch conjundrions, the bulk of 
^ the nerves feems much increafed, and thefe knotty 
' oval bodies, called by Falloppius corpora oil- 
^ varia, and generally now named ganglions, are 
^ formed. The coats of thefe knots are {b'onQ:er, 
^ thicker, and more mufcular than the whole nerves 

* which enter into them would feem to conftitute, 
' while the nervous' fibrils pafs through without 
^ any great alteration or change. I do not think 

* any author has yet made a probable ,conje6lure 
' of the ufe or defign of thefe ganglions, v/he- 

* ther they imagine them corcula expcllentia, re- 
' fervoirs, or elaboratories, neither can I give an 
' account of their ufe the ieaft fatisfaclory to my- 
^ felf. 

" From undeniable evident experiments, all a- 
« natomifls are now convinced that to the nerves 
' we owe all our fenfation and motion, of which 
^ they are the proper organs 5 and the fenfations 
' in the minuteft parts being very diftinft, there- 
' fore the inftruments of fuch fenfations muft have 

* diftinft origins and courfe to each part. Though 

F2 ^^all 



328 NERVES. 

'' a!i are agreed as to the effect, yet a hot difpute 
^' has arofe about the manner how it is produced, 
'^ viz. whether fenfation and motion are occafioned 
^' by avibration communicated to the nerves, v/hich 
*' thefe gentlemen fuppofe entirely folid and tenfe, 
" or by a liquid contained and moved in them. 
" The laft of thefe opinions I rather incline to, for 
" thefe reafons, becaufe the nerves proceeding from 
" the brain bear a great analogy to the excretory 
** duds of other glands. Then they are far from 
'* being fi retched and tenfe in order to vibrate. 
^^ And what brings the exiPience of a liquid in their 
'' cavities next to a dcmonftration, is the experim.ent 
'' fiifc made by Bellini^ and related by Bohn 
*' and pJTCAiRN, which I have often done with 
'' exad good faecefi 5 it is this : After opening the 
'' thQi-ax of a living dog, catch hold of and com- 
* ^ prefs the phrenic nerve, immediately the diaphragm 
:'' c::-afes to a<ft j remove the compreffing force, that 
*' mufcle again contracls 3 gripe the nerve with one 
'' hand fome way above the diaphragm, that fep- 
'• tumiis ^active; then with the other hand flrip 
'' dowa-the nerve irom the firft hand to the dia- 
** phragm, tliis mufcle again contrads^ after once 
'' or twice having Gripped the nerve thus down 
'•^ or exhaufted thQ liquid contained in it, the muf- 
'' cle no more ads, fqueeze as you will, till the 
'' firft hand is taken away or removed higher, and 
*^ t!ie nerve ilripped, i. e. the liquids in the fupe- 
*' rior part of the nerve have free accefs to the dia- 

" phragm 



NERVES. 229 

^* phragm, or are forced down to it, when it again 
" will move. Now if this liquid {hould be grant- 
" ed us, I am afraid we (hall be ftiil as mu(?h at 
" a lofs to account for fenfation and motion as 
^' ever -, and therefore all I fhall affume is what is 
" founded on experiments, that thefe two affivons 
*' do depend on the nerves ; that feniations are 
*' pleafant as long as the nerves are only gently af- 
*' fe6led without any violence offered them ; but 
*' as foon as any force applied goes beyond this, 
'' and threatens a folntion of union, it creates that 
*' uneafy fenfation, pain : The nerves, their fource 
*' or their coats being vitiated, either convulfion or 
*Vpalfy of the mufcles may enfue. 

*' The nerves are diflinguifhed into twoclaffes, 
** of the encephalon and medulla fpinalis ; of the 
" firfl: there are generally ten pair reckoned, of 
" the laft thirty. I (hall defcribe the nerves in 
" the fam.e order in which they are generally 
" ranked, though it is not poiTible to profecute the 
'' diffedlion of them after the fame manner; but 
'* to fupply this, I (liall mention alfo the order 
'^ wherein they may be all demonftrated on one 
*' fa bje^. When I affign the origin of any nerve 
<^ from any particular part, I defire it may be un- 
'' derflood of that part of the furface of the me- 
" duUa where the nerve iirft appears -, for by this 
" method we fliall fl^iun any dilpute with thofe au- 
«' thors who trace their rife too minutely, and per- 
** haps be lefs liable to miitake or to deceive our 

P 3 " readers 



230 NERVES. ' 

^' readers. Nor (liall I be over anxious about the 
«' terminations of the minimse fibrillar, fince it is 
«« not pofiible to trace them ad ultimos fines, nor 
«' dol think very neceffary for explaining any phs- 
" nomena, v^hile very often in a multiplicity of 
^* words the v^hole defcription comes to be obfcure 
^^ or unintelligible. 

*' Of the ten pair proceeding from the encepha- 

** loD, the firft is the olfaftory, which in brutes^ 

'^ juftly enough, has the name of proceffus ma- 

'^^ millares beflov/ed on them, being large and hol- 

^' low, and are indeed evidently the two anterior 

«' ventricles of the brain produced ; which flrudure 

^' and the lymph confliantly found in them, induced 

^^ the ancients to believe that they ferved as emun- 

^' dories to convey the fuperabundant mucus from 

^*' the cold moid: brain to the nofe 5 bat in man 

^' they are fmall, long, and without any cavity, 

<« rifing from that part of the brain v/here the ca- 

^« rotid arteries are about to enter, and running un- 

^^ der the anterior lobes of the brain become a Iktie 

^' larger, till they reach the 03 cribriforme, into 

^^ the foramina of v/hich the fmall filaments infi- 

^* nuate themfelves, as upon gently pulling thofe 

-^' nerves, or after having cut them very near the 

'^ bone, is evident, and are immediately fpread on 

^' the membrana nariiim. Their tender ftrudure 

«* and fudden expaniion on iuch a large farface, 

?* make it impoffible to trace them on the mem^ 

^^ brane of the noftrils, which has given ibme handle 

^' to 



NERVES. 231 

" to feveral authors to deny them the ftrudlure or 
" ufe of nerves. 

" The fecond are the optic, which arife finglo 
^* from the thalami nervorum opticorum, and then 
'^ uniting at the fore part of the cella turcica, they 
^' feem to be pretty much blended } afterwards they 
" divide, and running obliquely forwards, pafs out 
*^ at their. proper hole of the fphenoide bone, and 
*^ enter the globe of the eye to be expanded into 
*' the membrana retina. From this conjundlion of 
** thefe nerves, authors generally endeavour to ac- 
*^ count for our feeing objeds fingle, whereas we 
" have reafon to believe fifhes, the chamelion, &c. 
" whofe optic nerves fimply crofs one another with- 
*' out any fuch union, do fee objeds alfo fingle, 
" fince they foexadtly rufli on their prey > where- 
" as if thofe authors affertions were true, they 
'' would oftener catch at the fliadow than the fub- 
'^ fiance. The blood veffels running through the 
** middle of thefe nerves, and the ramifications of 
" the retina are very obfervable, whence we may 
" deduce the reafon of Picard's experiment of 
'^ fuch objedts as fall on the entry of the optic nerve 
'' being loft to us, and hence alfo an account may 
" be given of an amauroiis or gutta ferena. 

*• The third pair of nerves firft appear at the 
** anterior part of the proceiTus annularis, and go- 
*' ing out at the foramen lacerum are diftributed to 
" the globe of the eye 5 mufculus redus Fallopii, 
*■« attoUens, adducens, deprimens^ and obliquus mi- 

P 4 '' nor 3 



232 N E R V E S. 

<« nors therefore this pair has jafdy got the name 

" of mctores oculi. 

«' The fourth pair, which are the fmalleft of 
" any^ derive their origins from the anterior lateral 
^^ part of the pfoceiTus annularis, and go out at the 
*' foramina lacera to be endrely fpent on the muf-* 
*' culi trochleares, or cbliquimajores oculorum, to 
*' which mafcles: chiefly the rotatory motion of the 
^^ eyes in ogling, and the 'advance of the eyes for-- 
" ward in ftaring and fury, is owing ; for which 
«^ reafon anatomifcs have called thdc nerves pathie- 
"' tici. 

" The fifth pair rife from the fides of the an- 
^" nular procefs, and after piercing the dura mater 
^^ divide into three branches; the firft of which is 
^^ the ophthalmic, which as it is about to enter the 
" orbit by the foramen lacerum, fends off a fmall 
^^ twig that aiiiits in the formation of the inter- 
" coftal, and then the nerve is ditlributed to the 
" glandula lacrymalis, fat, membranes, and palpe- 
'^^ brs of the eye, while it fends one confiderable 
'' branch through the orbiter internus anterior hole 
'^ to be loft in the membrana narium, and a fecond 
^^ paffes the foramen and fupercilia to fupply the 
'-' mufcles and teguments of the forehead. Hence 
^■^ we eafily difcover what part is affeded in that 
•^^ painful difeafe the megrim, when the eye ball 
^* and forehead are racked, and fuch a heat is felt 
^' within the nofe. Flence alfo we may learn how 
^^ the mufcles of refpiration come to be fo much 

' '^^ affeded 



N E p. V E S. 2^j 

«« affeded on the application of any acrid irritating 
*^ fubi'iance to the membrana narium, as to pro- 
" duce that violent convulfiv€ motion^ iheezin^. 
«' The iecond branch of the fifth pair, which may 
" be called maxillaris fuperior, paffes out through 
'- the foramen rotundurn offis fphenoidis, and im- 
*^ mediately gives nerves to the fat under the crota-* 
^* phite mulcle, and to the palate, finus fphenoi- 
'^ dalis, and noftrik The remaining trunk infinu- 
" ating itfelf into the channel on the top of the 
"' antrum Highmorianum, to which cavity and to 
" the teeth of the upper jaw it gives fmall twigs, 
*' at lafi: comes out at the orbiter externus hole, 
*' and is fpent on the mufculus orbicularis palpebra- 
'* rum, nofe, and upper lip, where fome branches 
" of the feventh pair feem to unite themfelves to 
** the twigs of this. The third branch, or max- 
*^ illaris inferior, goes out at the foramen ovale, or 
*' fourth hole of the wedge-like bone, and foon 
** fpHtting into a great many branches, is diftri- 
*' bated to the mufculus crotaphites, maffeter, pte- 
" rygoidcs, digaftricus, buccinator, mylohyoideus, 
<' geniohyoideus, genio-gloffus and bafio-gloffus, 
** glandula fublingualis, maxillaris inferior, anci 
" parotis, to the external ear, where it feemstojoin 
^^ the portio dura to the fubflance of the tongue, 
" in which it is pretty much confounded with the 
^' ninth pair: from the root of this laft branch 
*' the chorda tympani is refleded. The laft rami- 
^' fication of this branch which I ihall mention, is 

*' that 



234 N'ER V E a 

«« that which enters into the canal of the lower jaw, 
«« furnifhes the teeth there^ and comes out at the 
«' chin, on which and the lower lip it is beftowed ^ 
«« at this place it is again conjoined to the feventh 
«« pair. From this fliort ilcetch of the large fifth 
«* pair of nerves^ and by obferving feveral ph^no- 
^^ mena which happen to thofe parts to v/hich they 
" are diflributedj v/e miglit have a much farther 
«* confirmation of the general doftrine of nerves 
«* deliveredj and fee, atleaft, the way pathed to a 
*' rational account of thefe phasnomena^ for reafon- 
«« ing on which we fhould not other wife have the 
<« leafc groand. V/e can, for example, from the 
** chorda tympani and the nerves of the teeth, be- 
^* ing derived from the fame common trunk, un- 
*« derftand hov/ the found of any vibrating body 
«« held between our teeth is ienfible to us, when 
«' another cannot poffibly hear the leaft on't. By 
«« the like role we know why in a violent tooth- 
<^ ach the mufcles of the face are fometimes con- 
^^ valfed ; nor (hall we be furprized to hear one 
<« plagued with the ach in his upper teeth, com- 
«« plain of a gnawing pain deep feated in the bones 
<« of his face, or to fee his eye-lids much fwelled^ 
f' or the tears trickling down in great abundance; 
«^ whereas the lower teeth aching, the ear is pain- 
«« ed, and the £iliva fiov/s in great quantities. We 
^' may have forae diftant viev/s of fome foundation 
<* in reafon for the cure of the tooth-ach, by ftrong 
** compreffion of the chin^ or by applying biifters 

^^ behind 



NERVES. 235 

" behind the ears, or by buraing behmd or on the 
" ear. Among a great many inftances of the good 
*^ eifed of the adual cautery in fuch a cafe, I fhall 
" give one which feems to me remarkable : I. M. 
" was feized with the tooth -ach, a convulfion of 
" that whole fide of his face fo Howled whenever 
*' the pain became acute, or he attempted to fpeak; 
«' after he had undergone bleeding, purging, fa- 
'' livation, fetons, &c. without any benefit, he 
'^ was cured by applying a fmall cauterifing iron to 
" the antihelix. 

'' The fixth pair of nerves arlfing from the 
<' fore part of the corpora pyramidalia, after piercing 
*< through the dura mater, give ofFa branch, which 
'^ joined with the refleded twig of the ophthalmic 
" branch of the fifth pair 3 forms the original of 
** the intercoftal, pafTes through the foramen lace- 
*< rum to be fpent entirely on the mufculus ab- 
" dudtor oculi : Suppofing this nerve to fupply ever 
^' fo little lefs than a due proportion of liquidura 
" nervofum, an involuntary ftrabifmus will be oc* 
«' cafioned. 

"Though the fifth and fixth pair of nerves 
^' form entirely the beginning of the intercoftal 
^' before it goes out of the fcull, yet becaufe fe* 
<' veral other nerves contribute towards the forma- 
«' tion of its trunk before it fends off any branches, 
" I fhall fuperfede the defcription of it t,ill the ori- 
^^ ginal nerves are fpoke to, 

<c The 



236 NERVES. 

" The feventh pair appears coming out from 
«f the lide of the root of the annular procefs, and 
<« entering the meatus auditorius internus, and im- 
" mediately dividing, one part foon lofes its firm 
" coats, and is expanded on the inmoft camera of 
" the ear, while the other paffing through the a- 
*' qusedudtus Fallopii comes out of the fcull involved 
" in all its coats between the ftyloide and maftoide 
^* proceffes j whence we fee the reafon of the firft 
*' being named portio mollis, and the other dura : 
*' This lafl: after its exit fupplies the mufculi obliqui 
" capitis ftyiohyoidei^ ftylogloffi, and flylopharyn- 
^* gaei, and platyfma myoides, on which, and to 
** the {kin of the neck, a great number of its fmall 
*^ filaments run, which are fometimes cut in open- 
*^ ing the jugular vein, whence pain at firft, and a 
** little numbnefs afterwards. The fuperior branches 
'^^ of it fupply the parotid gland, external ear, and 
^* whole fide of the face as far forwards as the chin. 
** It is faid to comuinnicate thrice with the fifth 
** pair, and twice with the fecond vertebra. Whe- 
*^ ther may not we hence fee fome reafon why the 
*^ head isfo foon moved by the impreflion of found 
^* on our ear ? 

^' The eighth pair of nerves derive their origin 
^* from the fide of the bafis of the corpora olivaria, 
" where their loofe filamentous texture is very con- 
*' fpicuous; then running to the hole common to 
*' the oiTa temporum and occipitis, they are there 
*-' joined by the accefTorius Willifii, which has its 

" beginning 



NERVES. 237 

^^ beginning from the two or three fuperior nerves 
<« of the medulla fpinalis, and mounts upwards 
«^ thither, to pafs out with the eighth pair, at that 
^' common foramen juii now mentioned : Very foon 
'' after they, wrapped up in the fame coat, have 
" got out of the cranium, the accelTorius feparates 
" from its companion, and after paffing through 
*^ the middle of the mufculus maftoideus, is lofc in 
** the mufculus trapezius and rhomboides fcapul^j 
" while the large trunk, which, from the great 
" number of branches it fends off, obtains the name 
** of vagus, runs ftrait down the neck, near the 
" carotid artery, in its courfe giving feveral branches 
^' to the larynx : When entered the thorax, it fplits 
" into two; the anterior ferves the pericardium 
'« fends branches to join with thofe of the inter- 
" coftal that go to the heart, and then on the right 
<« fide turns round the fubclavian, and on the left 
'« round the dudus arteriofus, to mount again 
<* upwards at the fide of the cefophagus to be loft 
'^ in the larynx. This recurrent branch it is that 
*' we are earneftly cautioned to avoid in broncho- 
" tomy, though by reafon of its deep fi tuation we 
<' are in no hazard of it. If both thefe nerves 
" were cut, it is probable the voice would not be 
" entirely loft as long as the fuperior branches ftill 
< « fupply the larynx. The pofterior branch of the 
" eighth pair goes along with the cefophagus, and 
" fupplies the lungs, the gula, and ftomach very 
*' plentifully : And as all ihiSj^Aerves beftowed on 

'' this 



238 NERVE S. 

" this vifcus enter at the fuperior orifice of it, the 
«« fenfation here muft be very acute ; whence Hel- 
«' MONT imagined the mouth of the ftomach to 
«« be the feat of the foul. What remains of this 
s« par vagum is adjoined to the intercoftal imme- 
" diately below the diaphragm. 

" The ninth pair appear firfl: at the inferior 
<^ part of the corpora pyramidalia, and march out 
*« at their proper holes of the occipitis, and after 
^< fending ofFfome nerves to the glandula thyroidea, 
^^ and mufculi fterno-hyoidei, and fterno-thyroidei, 
*^ are loft in the fubllance of the tongue. Authors 
«^ have difputed whether this ninth or the fifth is 
«^ the guftatory nerve j the old opinion in favour of 
<« the ninth is to me moft probable^ bccaufe the 
«f fifth is no where elfe employed as an organ of 
«^ fenfation, becaufe the ninth feems to penetrate 
«« the fubftance of the tongue more, while the 
" fifth is fpent on the mufcles. 

^< The tenth pair comes out from the beginning 
«^ of |:he medulla fpinalis, betwixt the os occipitis 
<« and firft* vertebra colli, and is all, except what 
«' goes to the ganglion of the intercoftal, fpent on 
" the mufculi obliqui, and extenfores capitis. 

" The only nerves proceeding from the ence- 
*' phalon not defcribed, are the refledled branches 
*' of the fifth and fixth, which indeed are fo fmall 
*' and pappy, and hid by the carotid artery as they go 
" out with it in its crooked canal, as not to be eafily 
«« traced 5 but whenever they have efcaped frpm the 

«' OS 



NERVES. 239 

*^ 03 petrofumj they are joined by branches from 
" the eighth, ninth, tenth, and firft and fecond 
'^ fpinal, and the iargeft ganglion of the body is 
" formed, from which the nerve named now inter- 
" coflal, goes out to defcend down the neck with 
^* the carotid, fupplying in its courfe the mufculi 
<^ flexores of the head and neck, and communicating 
*' with the cervical nerves. As the intercoftal is a- 
" bout to enter the thorax, it again forms a ganglion, 
'' from which the nerves to the trachea arteria and 
«' the heart are fupplied, which join with the 
«^ branches of the eighth, and pafs between the 
*' two large arteries and auricles to the fubftance of 
" that mafcle. Now let any one conhder the 
" egrefs of the intercoftal, and clofe courfe of it 
" and the eighth with the carotid artery, and this 
" manner of entry of the cardiac nerves, furely the 
*' alternate conftridlion and relaxation of the heart 
^^ will appear neceffarily depending on the difpoii- 
'' tion of thefe organs of motion, the nerves. The 
" intercoftal after this runs down on the fide of the 
" vertebra thoracis, having additional nerves con- 
" ftandy fent to it from between thefe vertebrs, 
" till it pafs through its own proper hole of the 
*^ diaphragm ; v/hence it again forms another gang- 
«^ lion clofe by the glandule renales, into which the 
*« eighth pair enter. From fuch a knot on each 
«' fide, the nerves of the guts, liver, fpleen, pan- 
*^ creas, and kidneys are derived; nay the extremi- 
y ty of this nerve is fent down to the pelvis to fup- 

-ply 



^^o^ NERVES. 

*^ ply the parts there. Hence the great fympathy 
*< of thefe parts may be eafily deduced, and a rea- 
«' fon may be given of the violent vomiting that 
*' commonly attends a nephritis, and of the belch- 
*' ing, colics, and ftomach-achs, which often enfue 
<^ on the obftrudions of the menfirua. 

"Before I proceed to the fpinal nerves, I 
«^ {hall fa down the order in which thefe nerves 
*^ already defcribed, are to be diiTefted, in order to 
'^ demonftrate them all in one fubjeft, but to them 
" mo ft alliime the three firft cervical nerves, the 
" reafon of which will be evident afterwards. 

** PoRTio DURA SEPTiMi, frontalis quinti, 
*^ facialis quinti, mentalis quinti, fpinalis fecundus, 
«' fpinalis primus, olfadlorius, ophthalmicus quinti, 
<« motorius oculi, patheticus fextus, opticus, max- 
" illaris inferior quinti, maxiiiaris fuperior quinti, 
" accefforius Willifii, nonus, decimus, odavus in- 
«* tercoitalis, portio mollis feptimi. 

*^' The thirty pair of nerves proceeding from the 
" medulla fpinalis are generally divided into four 
«* fpecies 5 of the neck feven, of the back twelve, 
«^ of the loins five, and of the os facrum fix. Now 
** as the medulla fpinalis has none of thefe inequa- 
** lities fo obfervable on the medulla oblongata 
*' encephali, the rife of the nerves is not fo accu- 
" rately defcribed, being only determined by the 
*< bones through which they pafs. 

"The firft cervical goes out between the firft J 
** andfecond vertebra^ and, after fending ofFbranches M 

"that * 



NERVES. 241 

«« that communicate with the tenth and fecond 
«* vertebrale, is fpent on the mufculus flexns colli, 
*^ fplenius, complexiis, and teguments of the occi-. 
" pitis, 

" The fecond cervical communicates with the. 
*^ ninth, and with the firfl and third of the neck, 
** and then is diftributed to the teguments of the 
'^ neck and fide of the head, and to the glandula 
** parotis and external ear, where k joins with the 
*^ portio dura. 

*« The third of the neck paffes out between the 
*' third and fourth vertebra, foon communicating 
** with the fecond, and fending down a large branch, 
*^ which being joined by another from the fourth, 
" forms the phrenic nerve that runs along the pe- 
** ricardium to be loft in the diaphragm. In this,- 
*^ courfe the right phrenic is obliged to make a fmall 
*' turn round that part of the pericardium which 
" covers ihe apex of the heart. Hence it is that 
" fuch as have flrong palpitations of the heart, feel 
*^ a pungent acute pain immediately above the right 
*' orifice of the ftomach. The other branches of 
" this third cervical are diftributed to the mufculus 
•^ trapezius and deltoides, and^to the tegunaents on 
" the top of the ihouider -, which, v/nh the de- 
*' fcription of the eighth pair, leads us evidently to 
*' the reafons of the divine Hippocrates's ob^ 
«* fervation, that an inflammation of the liver is, 
*' generally attended with a hickup, and a fuppu- 
** ration of that vifcus, with a violent pain on the 
^ Q^ "lop 



242 NERVE S. 

*' top of the ihoalder. However we are not hence 
<' to conclude fo generally, as I have obferved phy- 
<^ iicians frequently do, that if the hypocondria are 
*« affected, and this pain of the (houlder is felt, 
*' therefore the liver is luppurated ^ for any other 
*' caufe llimulating or liretching the nerves, fuchas 
•^ inflammation, wounds^ fcirrhous or fleatoma- 
*^ tous tumors, &c. may produce the fame efFe£L 

«' The fourth cervical, after fending off that 
** branch which joins with the third to form the 
*^ phrenic, runs ftrait to the axilla, where it meets 
*' with the fifth, lixth, and feventh cervicals, and 
*' firfl: dorfal that efcape in the interftices of the 
*' mufculi fcaleni -, and all of them are fo often 
*' conjoined ^nd blended, after they have given off 
*^ nerves to the mufcles of the neck, fcapula, arm, 
*^ and thorax, and to the teguments, that when the 
*« feveral ramifications go off in the axilla to the 
*« different parts of the fuperior extremity, 'tis im- 
*' poflible to determine which of them the branches 
*' belong to. The confiderable branches into which 
" they are divided, are fix ; thefe I fhall prefume 
*^ to give proper diftinguifhing names to, by which 

the defcription will be lefs confufed, and the young 

anatomifl's memory better aflifled to retain what 

is fo difficult to reprefent in words. 

" I. CuTANEus runs down the fore part of 
" the arm, and ferves the teguments, as far as 
*/ the palm of the hand and fingers. 

I «c 2. MuscuLo- 



cc 



<e 



cc 



NERVE S. ^ , 243 

" 2. MUSCULO-CUTANEUS, Or PERFORANS 

" CASSERii, paffes through the mnfculus coraco- 
*' brachialis, and after fupplying the biceps and 
*' brachiasus internus, is fpent on the teguments of 
*' the back of the cubitus and hand. =rY^ 

" 3. MuscuLARis, that runs down tne lore 
" part of the arm to be lofl in the mufculi flexores, 

carpi, digitorum, &c. 

4. Ulnaris, which fupplies the extenfores 
" cubiti, and teguments of the elbow, and then 
'^ paffing through the finuofity at the back of the 
*^ external condyle of the humerus, runs along the 
" ulna, where it gives twigs to the teguments and 
<' neighbouring mufcles; at length is loft in the 
"back of the hand, mufculi interoffei and lumbri- 
** cales in the little finger, and fide of the ring 
" finger next to this. The courfe of this nerve is 
" fufficiently felt when we lean on our elbow, by 
" the infenfibility and prickling pain in the parts 
« to which it is diftributed. 

" 5. Radialis goes down the fore part of the 
"arm, near the radius, bellowing branches in its 
" progfefs on the circumjacent mufcles, and at the 
" ligamentum annulare carpi fplitting, is fent to the 
" thumb, fore finger, middle finger^ and half of 
" the ring finger, and to the back of the hand. 

"6. ARTicuLARisruns almoft round the top 
" of the OS humeri, and ferves the mufculi exten- 
" fores cubiti, retradtores, and elevatores humeri. 

Q^ By 



244 NERVES. 

<f By a ftrong and continued preffare on thefe 
*« nerves, by crutches or any fach hard fabflance,. 
«« a paify and atrophy of the arm may be occa- 
*^ lioned. 

«' The twelve dorfal nerves all communicate 
^^ Vi^ith one another ^ as foon as they make their way 
" out betwixt the vertebrae, each of them gives a 
'^ pofterior branch to the mufculi eredlores trunci 
** corporis ; the firft, after having fent off the bra- 
*^ chial nei've, already defcribed, is after the fame 
*^ manner, with the fucceeding eight, bellowed on 
" the pleura and intercoftal mufcles ; the tenth and 
" eleventh are moil of them fent to the abdominal 
" mufcles J the twelfth communicates with the firft 
" lumbar, and is beftowed on the mufculus qua- 
" dratus lumbalis and iliacus internus. 
'^"'■^ The fifth lumbar alfo communicates and gives 
^ pofterior branches i the firft fends feveral branches 
*^ to the abdominal mufcles, and pfoas, and iliacus, 
*^ while others go from it to the teguments and 
«^ mufcles on the fuperior and anterior part of the 
^^ thigh, and the main trunk of it is loft in the 
" croral. The fecond paffes through the pfoas muf- 
^^ cle, and is diftributed much as the former. The 
«* third^is loft in the mufculus pedineus. Branches. 
^' proceeding from the fir ftj, fecond J and third, make 
^« op one trunk, which runs along the anterior 
'^^ part of the pelvis, and flipping through a fmalL 
" Snuoiity in the anterior part of the foramen mag-, 
^f Biim bffis ifchiij is ipent ia the mufculus tri- 

^^ ceps. 



N E R V E 3, 245' 

" ceps. This nerve is commonly known by the 
*' name of obturator^ or pofterior crural nerve. 
*' By the union of branches from the firft, fecond, 
"third, and fourth lumbar nerves, the anterior 
<« crural nerve is formed, Vv'hich running along the 
** mufculus pfoas, efcapes with the large blood-vef- 
" fels out of the abdomen below the tendinous ar- 
" cade of its mufcles, and is diftributed to the 
** mufcles and teguments on the, fore part of the 
" thigh : One branch of this crural nerve accom- 
** panics the vena faphena as far as the ancle. Novc^ 
" let us imagine the fituation of the kidney upon, 
" and the courfe of the ureter over thefe nerves, 
" and we fhall not be furprized, that in a nephri- 
*' tis the trunk of the body cannot be raifed eredt 
" without great pain 3 that the thigh lofes of its 
«' fenfibility, and that it is drawn forwards. The 
<* remainder of the fourth and the fifth lumbar nerves 
" join with the firft, fecond, and third that pro- 
*^ ceed from the os facrum : Thefe five, when 
" united, conftitute the largeft nerve of the body, 
<^ fo well known by the name of the fciatic, or 
«« ifchiatic nerve, which feems to be bigger, in pro- 
" portion to the part for the ufe of which it is, 
" than the nerves of any other part are 5 the de- 
'< fign of which may be to afford fufBcient flrength 
*' to the mufcles of the lower extremity, for ex- 
" erting a force fuperior to what is required in any 
*' other part of the body. When this nerve is any 
" way obltrudted, we fee how unable we are to 

0^3 ** fupport 



246 N E R V E S. 

«' fupport ourfclves, or to walk. The fciatic nerve 
^' then goes out at the large hollow, behind the 
" great tubercle of the os ifchium, and paffing 
<« over thj^ .qiiadrigemini mafcles, runs down the 
«^ pofterior part of the thigh, giving off, every 
" where as it goes, nerves to the teguments and 
^^ mufcles of the thigh and leg. At the ham it 
«f fplits into two; the fmaller mounts over the fi- 
^^ buia, and ferving the mufculi peronei, flexores 
*' pedis, and €xtenfores digitorum, is continued to 
*f the toe3 along the broad of the foot, while the 
*^ larger trunk finks under the mufculi gemelli, and 
" then divides ; one is fpent on the mufcles at the 
*' back of the leg and teguments, while the other 
^' is continued by the inner ancle to the foot, and 
*« then jrubdivides; one branch is diilributed after 
^' the iame- manner. as the ulnaris, and the other as 
^* the radialis in the hand. 

_ " The other nerves, that come out of the os 
^^ facrum, are fent to the organs of generation, muC- 
^* cull levatores ani and obturatores. 

" These nerves of the medulla fpinalis may alj 
^' be diifeded and demonftrated in the fame order 
^■' in which they are defcribed." For this accurate 
defcriplion of the nerves I am obliged to Mr. Mon- 
po. 

The nerves feem, when examined with a mir 
crcfcope, to be bundles of ftrait fibres not commu- 
nicating with one another : And I am inclined tQ 
*-ink, |:hat every the mmptefl nerve, terminating 

\n 



N E R V E S. 247 

in any part, is a diftind: cord from its origin in the 
brain or fpinal marrow 3 or elfe I do not fee how they 
could produce diftindt fenfations in every part ; and 
the diftind points of fenfation throughout the body 
are fo very numerous, that the whole body of nerves 
(which taken together would not make a cord of an 
inch diameter) muft be divided into fuch a number, 
to afford one for every part that has a diftindt fenfa- 
tion, that furely fuch a nerve would be too fmall to be 
{cQn by the beft microfcope. They all pafs in as 
diredl courfes to the places they ferve, as is pofiible, 
never feparating nor joining with one another but 
at very acute angles, unlefs where they unite in 
thofe knots which are called ganglions, the ufe of 
which I do not pretend to know ; they make what 
appears to be a communication of mofl of the 
nerves on the fame fide, but never join nerves of 
oppofite fides. 

That the nerves are inftruments of fenfation, 
is clearly proved from experiments, but how they 
convey thofe fenfations to the brain, is matter of 
difpute. The moil general opinion is, that they 
are tubes to contain animal fpirits, by whofe mo- 
tions thefe fenfations are conveyed : And diligent 
enquiry has been made to difcover their cavities, 
but hitherto in vain -, and if each nerve is diftinct 
from its origin, as I have endeavoured to (hew, and 
too fmall to be the objed of the beft microfcope, 
I do not fee how fuch cavities are liketQ,be difco- 

Q^: vf-^-v-^ mdt , • vered. 



24S NERVES. 

vered. Neverthelefs nerves may be tubes, and pof- 
fibly a fluid, whofe cohefion is very little, and 
whofe parts no finer than light, may move freely 
in them* Thofe v^ho deny animal Ipirits in the 
nerves, fuppofe that the fenfation is conveyed by a 
vibration. To Vv^hich it is objeded, that they are 
flack, moiil, and furrounded with foft parts, and 
are therefore unfit for vibrations, as indeed they are 
for fuch as are m-ade on the Airings of a mufical 
inftrument ; but the minutefl: vibrations, fuch as 
they cannot be v^ithout, may, for ought w^e know, 
be as fufficient for this end, as the impulfe of light 
upon the retina, is for the fenfe of feeing. So that 
perhaps fenfations m.ay be conveyed either, or both 
ways. However, it being ufually taken for granted, 
that it mufl; be one of thefe ways at leafl:, the ad- 
vocates for each have rather endeavoured to fupport 
their opinions by arguments againft the probability 
of the other, than by reafons offered for their own. 



TAB. XXL 



isi) orfw sloriT Mt^ih ni 
•iS\ odi 3££lrdloqqLfi .^^svpn 

xbaiiOTiiil bns ^ftiom .^AobU. 

:i no 3bi],m t)1£ 8B doiJ} 'icf 
ijnicn odi Jud f Jn^moii) i; 

i^ 8idj i(A Jnobrfio 



TAB.XXI. 



P.24p. 






( 249 ) 




TAB. XXL 


I 

2 


Larynx. 

The internal jugular-'' 


1 


3 


The fubclavian vein. 


4 


Cava defcendens. 


5 


The right auricle of the heart. 


6 


The right ventricle. 


7 


Part of the left ventricle. 


8 


Aorta afcendens. 


9 

lO 


Arteria pulmonalis. 
The right lobe of th€ 
cut off to j(hew the 


5 lungs, part of which is 
great blood- veffels. 


11 


The left lobe of the lungs. 


12 

13 


The diaphragm. 
The liver. 


H 


The ligamentum rotundum. 


^5 


The gall-bladder. 


i6 


The flomach, preffed 
left fide. 


I by the liver towards the 


^7 
i8 


The fmall guts. 
The fpleen. 





TAB. XXII, 



{ 250 ) 

TAB. XXIL 

I The under fide of the liven 

2 Ligamentum rptundum. 

3 The gall-bladder. 

4 The pancreas. 

5 The fpleen^ 

6 The kidney. 

7 Aorta defcendeps. 

8 Vena cava afcendens. 

9 The emulgent vein. 

I o A probe under the fpermatic veflels and the ar- 

teriamefenterica inferior, and over the ureters, 

I I The ureter. . 

1 2 The iliac veflels. 

13 The re6tum intefdnum. 

14 The bladder of urine. 



TAB. XXIII. 



TjMa. xxn. 



/?2^^. 




T^^^B.xxni. 



. P,25/. 





TAB. XXIII. 

1 Part of the inteftinum jejunum. 

2 The valvulae conniventes, as they appear in 

a dryed preparation, 

3 The venas ladeae arifing from the gut, and 

palling through part of the mefentery. 

4 Part of the defcending aorta. 

5 Arteria coeliaca. 

6 Mefenterica fuperior. 

7 Emulgentes. 

8 Spermaticse. 

9 Some of the branches of the mefenterica infe- 

rior that are beftowed upon the guts. 



TAB. XXIV. 



( 252 )■ 

TAB. XXIV. 

1 Extreme branches of the vena porta as they 

arife from the guts. 

2 All the branches of the vena porta united before 

it enters the liver* 

3 The branches of the vena porta as they are dit 

tributed in the liver. 



TAB. XXV. 



T.AB.XXIV: 



^.232. 





w 



;k 



^ 




T^=yi.xxv. 



^•2^3- 



-•-! W:. W<)% 







-^/z 



t 



ML'/' 




N^^s:-^- 



( 253 ) 

TAB. XXV. 

1 Branches of the vena cava in the liver. 

2 Part of the vena cava afcendens, 

3 Part of the right auricle. 

4 Cyflis hepaticus« \- 

5 Dudlus cyfticus, 

6 Dudus hepaticus. 

7 Dadus pancreaticus, 

8 The entrance of the ductus communis into the 

duodenum. 



TAB. XXVI. 



( 254 ) 
TAB. XXVI. 

1 The left fubclavian vein. 

2 The internal jugular. 

3 Part of the vena azygos. 

4 Part of the defceading aorta. 

5 The fubclavian artery. 

6 Some of the ladteals entering the receptaculum 

chyli. 

7 Some lymphatics entering the receptaculum 

chyli, 

8 9 Duftus thoracicus. 

lo The entrance of the thoracic du£l into the 
fubclavian vein. 



TAB. XXVII. 



TAB. XXVI. 



^2^^. 







TAB. XXVII. 



^•2^^. 




( ^55 ) 
TAB. xxvir. 

1 The humeral artery. 

2 Cubitalis fuperior. 

3 Cubitalis inferior, which ends in the hand and 

the fingers, and communicates with the cubi- 
talis fuperior under the mufcles of the thumb, 

4 The place where the cubitalis media is given off. 

5 The fuperior cubital nerve. 

6 The inferior cubital nerve, which pafies under 

the inner extuberance of the os humeri; 
both thefe nerves give off branches as they 
pafs, and end in the thumb and fingers. 



TAB. XXVUL 



(256) 

TAB. XXVIII. 

1 Part of the biceps flexor cubiti. 

2 The fafcia tendinofa from that mufcle, whichr 

is liable to be pricked in bleeding in the ba- 
filic vein. 

3 The humeral artery, on each fide of which is 

a large vein. 

4 Vena cephaiica. 

5 Mediana. 

6 Bafilica. 

7 A tumor formed in the centre of the cubital nerve 

a little above the bend of the arm -y it u^as of 
the cyflic kind, but contained a tranfparent 
jelly i the filaments of the nerve v\^ere divided 
and ran over its furface. This tumor occa- 
fioned a great numbnefs in all the parts that 
nerve leads to, and exceffive pain upon the 
leaft touch or motion. This operation was 
done but a few weeks fince, the pain is en- 
tirely ceafed, the numbnefs a little encreafed, 
and the limb, as yet, not wafted. 



TAB. XXIX. 



TAB.XXVIII 



P. 2.5^. 





TAB. XXIX. 



^'237' 




( ^S1 ) 

TAB. XXIX. 

. 1 The medulla fpinalis, from v/lience arife the 
nerves that pafs out between the vertebra, 

2 The brachial nerves. 

3 The beginning of the cauda equina. 

4 The anterior crural nerves. 

5 The pofterior crural nerves. 

6 The defcending intercoftal. 

7 Nerves of the neck. 

8 The brachial nerves. 

9 A ganglion in the defcending intercoftal nerve. 
JO Branches fi-om the intercoftal nerve to the 

vifcera. 

1 1 A probe pafTed under fome of the intercoftal 

nerves that pafs out between the ribs, 

12 The anterior crural nerves. 



K TAB. XXX. 



(258) 
TAB. XXX. 

1 The animalculse in femine mafculino, as they 

appeared in a microfcope, in a fpace as fmall 
as a pin's head. 

2 Thp circulation of the blood in a fifties tail, as 

it appeared in a microfcope. 

3 An artery as it is fpread in a membrane. 

4 A vein as it is fpread in a membrane. 



THE 



Tj^B.XXX. 



P- 238- 



\ 



mfi£ 





Ybo3 



¥1 



■-^ ,^^m ^v^ i^'- 



( 259 ) 



THE 



ANATOMY 



OF THE 



Human Body. 



BOOK IV. 

CHAPTER I. 

Of the urinary and genital parts of men^ together 
with the glandules renales, 

THE urinary parts are the kidneys with 
their veffels and bladder of uriiie. 
The kidneys of men are like thofe of 
hogs ; the two weigh about twelve ounces 5 they 
are feated towards the upper part of the loins upon 
the two lafl: ribs ; the right under the liver, and a 
little lower than the other, and the left under the 
fpleen. Their ufe is to feparate the urine from the 
bleed, which is brought thither for that purpofe 

R2 by 



26o URINARY AND GENITAL 
by the emulgent arteries ; and what remains from 
the fecretion, is returned by the emulgent veins, 
while the urine fecreted is carried off through the 
ureters to the bladder. I have, in three different 
fubjeds, taken ftones out of the loins, which had 
made their way from the kidneys through the muf- 
cks to the common integuments, where, upon 
opening the (kin only, the ilones appeared with a 
quantity of matter and urine. We have heard of 
operators who have cut for the fione in the kidneys . 
but I v/ill venture to affirm, that thofe cafes were 
no other than thefe,: but unfairly related. 
' 'The- ureters are tubes about the bignefs of goofe- 
^qiiilk- and about a foot long 3 they arife from the 
hollow fide of the kidneys, and end in the bladder 
near its neck, running obliquely for the fpace of 
?ii inch between its coats 3 which manner of enter- 
ing is to' them as valves. The beginning of the 
ureters in the kidneys are the tubuli urinarii, which 
^ Jdini^^ fehtiJtbe^ipdfe in each kidney. Between 
the tubuli urinarii^: authors have remarked Tmall 
papilte; and the cpartS: which are diffinguifhed by 
a clearer colourj, they call glandule. 

The bladder of urine is feated in a duplicature 
of ihe peritoneum in the lower part of the pelvis 
of the abdomen 5 its fhape is orbicular, and its' 
coatSfare:fche feme ^th thofe of the guts and other 
hollow mufcles- ateady defcribed 5 viz. an exter- 
nal membranous, a? middle mufcular, which is the 
nwfculusdetruibr urins,. and an inner membranous 



coat. 



PARTS OF MEN. 261 

coat, exceeding fenfible, as is fully {hewn in the 
cafes of the ftone and gravel. The ufe of this 
nice fenfe is to make it capable of that uneafinefs 
which excites animals to exclude their water, when 
the bladder is extended. This fenfe is fo delicate, 
that no fluid but natural urine can be long endur£4, 
even pale urine, or urine with matter 4% % in?.^ 
degree excite the fymptoms of the ftone, and force 
the perfon to void the urine. Sometimes much 
matter from the kidneys will excite vehement fymp- 
toms ; and this being found in the urine, and the 
pain being obferved in the bladder only, the kidneys 
having little fenfe of pain, it is ufually accounted 
for from ulcers in the bladder, which I have never 
found one inflance of in all the numbers that I have 
opened in this cafe. Indeed the bladder is fometimes 
ulcerated, but that dellroying part of the inner coat, 
the others flretch and ulcerate till the urine burfts 
through into the cellular membrane of the perito- 
neum, and caufe a mofl mi ferable death. This cafe 
i^ very rare in men, and much more foin.women. 
1 have feen cancerous ulcers open the bladder into 
the uterus, but thefe, I think, have begun in the 
uterus. All thefe cafes have fymptoms like the 
ftone i and not thefe only, but all difeafes of the 
uterus which diflurb the bladder, and even impo- 
ft:umations or tumors that prefs upon the bladder, 
all give the fame fymptoms vnth the ftone : Except 
that of a needlefs difpoiirion to ftooi at the time of 
making water. Some anatcmifts not thinking how 

R 3 foon 



262 URINARY AND GENITAL 

foon fluids taken into the flomach, and not retain-^ 
ed there by being mixed with folids, may pafs into 
the bluod, as the efFeds from drinking ftrong liquors 
or laudanum, or drinking without eating when we 
are hot, fufficiendy fhew^ ; and alfo not confidering 
the ihortnels of the courfe from the flomach to the 
kidneys this way, together with the fize of the emul- 
gent arteries, and the velocity of the blood in them, 
have imagined 9,pd affirmed, that there mud be fome 
more immediate courfe from the flomach or guts to 
the bladder V and not confidering either how fuch a 
courfe would have interrupted one great end in the 
animal cficonomy, orijiat veffels fit to fill the blad- 
der fafter than the ur£^tei;Si mull have been too large , 
to be concealed 3 nor, which proves it beyond con- 
tradidion, that the bladder is empty when the kid- 
neys ceafc tp .do tliek ^office j which is frequently 
taken for a fappreflioa of urine in the bladder. 
If in this laft cafe, upon making a prefliire on the 
region of tlie bladder,, the patient does not feel great 
pain, it is fcarce worth while to pafs a catheter to 
fearch for urine. In fuppreflions of urine whe- 
ther merely inPiammatory, or from the gout, or 
from an inflamed ilridlure in the urethra, I have 
found nothing fo effectual as bleeding and purging. 
In a fanguine large man, where the penis was too 
much inflamed to fufFer the catheter to pafs, I took 
away three times twenty four ounces of blood, and 
gave a purging clyfter, and two flrong purges, all 
within the fpace of twenty hours, which faved 

the 



PARTS OF MEN. 263 

the patient, and delivered him from excellive tor- 
ment. Such pradice may feem very fevere, but 
in this cafe no time is to be loft; if the urine can 
be drawn off, this method of cure is ftill the fame, 
but to be pradifed in a gentler manner. 

Glandule renales are two glaiiBs' featetf 
immediately above the kidneys, of no certain figure, 
nor do we know their ufe ; blit always paint and 
defcribe them with the urinary parts, becaufe of 
their fituation : In a very young foetus they are 
larger than the kidneys, and in an adult but a little 
larger than in a foetus. They receive a great many 
fmall arteries, and return each of them one or two 
veins. In their infide is a fm.all finus, tincSured 
with a footy-coloured liquor, ^/^^n ; bjUa^aoj cid v3 

The teftes are feated in tBb' fcrotum ; their 
office is to feparate the feed from the blood ; they 
are faid to have four coats, two common, and 
two proper. The common are the outer fkin and 
a loofe membrane immediately underneath, called 
dartos. The firft of the proper is the proceffus Va- 
ginalis ; it is continued from the peritoneum to the 
tefticle, which it enclofes with all its veffels, but is 
divided by a feptum, or an adhefion immediately 
above the tefticle, fo that no liquor can pafs out of 
that part of this membrane which enclofes the fper- 
raatic veffels into that which enclofes the tefticle. 
Large quantities of water are fometimes found in 
either or both of thefe davities, which difeafe is 
eafily remedied by a pundure with a launcet; but 

R 4 rarely 



264 URINARY AND GENITAL 

rarely cufgd without opening the cavity where the. 
W2djcr immmtmkd^ as in linuous ulcers. This I 
h^ytt doDC, and feen done feveral times, but never 
thoiighit jth^ eiiEe worth the trouble and pain the 
patient underwent. The true hernia aquofa is from 
the abc^QpeitiS which either extends the peritoneum 
into tfci^Jjfef#mB^;<l)i:t';breaks it, and then forms a 
ne^^ iif^^xbrajie which athickens as it extends, as in 
aneariiinSi.aE^i;Utheidmatous tumors, This may 
be decided h% art injeffion, which will ihew by the 
arteries. that inoiirifli it, whether it is a produdtion 
from the peritoneum^. or a new membranous bag 
formed, in the for otum-: 'However the dropfy in 
this ciftj f6jr, fiich^ifei.ipioperly is, rarely admits of 
more thp^^^vplliativd ©Qte by pundure or tappings 
litenth^n<^^% of ^hq -£tbdomen, and this with 
fome cli:®QiJl|y,: jbecaufc the omentum uiually, and 
fometimes.et^e gilt, defcends with it. The other proper 
coat is the aihuginea^ w^hich is very flrong, imme- 
diately inclofcg the tefticles. The teflicles of a rat 
may be unravelled into diftinfl veffels ; and the tex- 
ture of the tefticles .of other animals appear to be 
the fame, hilt their' veffels are too tender, or co- 
here too much to be. lb feparated. The tefticles 
receive each one artery from the aorta, a little be- 
low the emulgents, which, unlike all other arte- 
ries, arife fm.all, and dilate in their progrefs, that 
the velocity of the blood m.ay be fufficiently abated 
for the fecretipnof fo vifcid a fluid as the feed. The 
right teilicle returns its vein into the cava, and the 

left 



PARTS OF MEN. 265 

kft into the emulgent vein on the fame fide, both 
becaufe it is the readieft courfe, and becaufe, as au- 
thors fay, this fpermatic vein would have been ob- 
ftru6led by the pulfe of the aorta, if it had croffed 
that veiTel to go to the cava. 

A GENTLEMAN, whom I caftrated many years 
fince, who trufted too much to his own refolution, 
and refuting to have any one prefent to hold him, 
except my affifcant, during the operation, moved 
fo much that the ligature which tied all the veffels 
v.'ith the procefs together, flipt, and only tied the 
procefs over the ends of the veffels : Which being 
perceived foon after the operation, I cut the liga- 
ture, and took out the extravafated blood, and tied 
the artery alone, which gave but little pain, and it 
digeftedoff in a week's time, and the wound being 
afterwards ffitched, though the tefticle weighed a 
pound, it was per fedly well in five weeks; which 
is in lefs time than the ligature fometimes requires to 
be digefted off, when the procefs and all the veffels 
are tied together. However if this cafe is not fuf- 
ficient to recommend doing this operation by tying 
the artery only, it may be fufficient to recommend, 
extraordinary care in doing of it the ufual Vv'ay, 
for if the blood had found an eafy paflage into the 
abdomen, the patient might have bled to death. 

On the upper part of the tefticles, are hard bo- 
dies called epididymi , which are evidently the be- 
ginning of the vafa deferentia, I have unravelled 

them 



266 URINARY AND GENITAL 
them backward, in fingie vefielsj and then into 
more and fmaller, Hke the excretory veffels of other 
glands. 

Vasa Deferentia are excretory dufts to 
carry the elu^baiatecl iced into the veficulse feminales. 
They pals from the epididymi of the tefticles, to- 
gether wiih the blood- veffels, till they have en^ 
tered the rrufcles of the abdomen, and then they 
pafs under the peritoneum, direftly through the 
pelvis, 10 the veficulse feminales. 

Vesiculje Seminales are two bodies that 
appear like veficles ; they are feated under the blad- 
der of mine, near its neck; they may be each of 
them unfolded into one fingie dud:, which dif- 
charges into the urethra, by the fides of the ro- 
ftrom gallinaginis, which is an eminence in the 
iinderfide of the urethra near the neck of the 
bladder. In thefe veficles or dudts the feed is re- 
pofited againft the time of coition; but in dogs 
ihere are no loch veficles, therefore nature has 
contrived a large bulb in their penis^ which keeps 
them coupled, feemingly againft their inclinations, 
till the feed can arrive from the tefticles. The feed 
paffes from thefe veficles in men, and even from 
the vafa deferentia, in time of coition, through 
the proflate glands into the urethra, as in thofe 
animals that have no veficulse feminales, for when 
the duds into the urethra are diftended, that is 
the dired courfe from the vafa deferentia, as 
well as..fi-om the vcficute feminales. 

PROSTATiE 



PARTS OF MEN. 267 

pRosTATjE are two glands, or rather one, 
about the lize of a nutmeg : They lie between 
the veficulae feminales and penis, under the ofla 
pubis, almoft within the pelvis of the abdomen. 
They feparate a lympid glutinous humour which 
is carried into the urethra by feveral duds, which 
enter near thofe of the proftatas. This liquor feems 
to be defigned to be mixed with the feed in the 
urethra, in the time of coition, to ihake it flow 
more eafily. If the venereal infecflion reaches the 
proftate glands, it will fometimes make large ab- 
fceffes, which are apt to form iinufes, and even 
make a paffage into the bladder. Upon the firft at- 
tack of this difeafe, I have prevented all this 
mifchief, by taking off the external fkin by in- 
fciflion, as far as the hardnefs of the tumour ex- 
tended, which draining very plentifully, the tu- 
mour has fubfided, and the patient been eafily 
(Eured ; but this cafe once becoming fiilulous, is 
very difficult indeed. It often is cured by open-^ 
ing the finufes and confuming the difeas'd parts 
by efcarotics -, but a much better and eafier way, 
\vhich I have often done, is to cut out all the 
fid ulcus and difeafed parts at once. 

Penis, its Ihape, fituation, and ufe, need no 
defcription. It begins with two bodies named 
crura, from the ofia ifchia, which unite under 
the offa pubis, and are there ftrongly conned:e4 
by a ligament. In its under part is the urethra, 
through which both the urine and feed pafs ; its 

fore- 



268 URINARY AND GENITAL 

fore-part as called glans, the loofe Ikin which co- 
vers it, praspotinm, arid the ftralt part of that fkia 
Gil the^nder fide, fraenum. The urethra is lined 
with a -Membrane filled with fmall glands, that 
feparate ^ mucus, that defends it from the acri- 
mony of the urine. Thefe glands are largeft near- 
eft ^the bladd^/^c Mr. CowPER defcribes three 
l^e glands o£ the urethra, which he difcovered j 
•%Wotof which are feated on the fides of the ure* 
llir^^^^near the ends of the crura penis ; to which 
he adds a third, lefs than the other, feated almoft 
"in the urethra, Sr little nearer the glands than the 
^rmer."" All 'thefe glands have excretory du6ls 
Irito the drethrav and from them are fecreted all 
the matLer which flows from the urethra in a go- 
^^drrrhcEa, whether venereal or not. In the venereal 
Ihfeilion, the urethra and the glands are firft in- 
^amed by the contagious matter^ that caufes a heat 
%^f urincf which abates as foon as the glands begin 
Wdifcharge freely, but: if by chance this difeafe 
^feeWtmues tiffany part of the urethra is ulcerated, 
the ulcer never heals without a cicatrix^ which 
^cenftrlc!s^tfie - urethra^ ■ and makes that difeaie 
'which is vulgarly call'd a caruncle. The inner 
"t^xtufeof the penis is fpongy, like the inner tex- 
ture of the fpleen, or the ends of the great bones, 
"It is ufually diitinguifiied into corpus cavernofum 
penis, gland-is, and urethra. The firft of thefe 
^^tiiakespart of the glands, -and is divided its whole 
'''' -.:.:. ^ length 



PARTS OF MEN. 269 

length by a feptum ; the other two are compofed 
of fmaller cells, and are but one body. On the 
upper fide of the penis are two arteries, and one 
vein called vena ipiius penis. The arteries are de- 
rived from the beginnings of the umbilical arteries, 
which parts never dry up, and the vein runs back 
to the iliac veins. The veim ipiius penis, being 
obftruded, the blood thajti-Gomes by the arteries, 
diitends the cells of the wliole penis, and makes 
it eredt ; but to prevent mifchief from this mecha- 
nifm, there are fmall collateral veins on the fur- 
face of the penis, that i;^rry back fome blood all 
the time the penis is ere(ft;5f jbut by; what power.tbe 
vena ipiius penis is obftrvufl^^, to i^r^thp. penis, 
I cannot conceive, unl^f5./A?^U^f?^ufcP)^f r^brqs 
conftridt it. Some thi»l5qt^e-«jji;fcl^li ^reSores 
penis do it, by thruiling^^h^j,^g§i^^^ainft .the os 
pubis i but they feem nplu^^f^o^cy^j^gkntiy for 
fuch an office ; befide% ^f j^'iPtfilk^ C^APi. the 
lower fide of the penis i§i^.fufS^^e^,^ar: ardhcial 
preflure, which may bqonWil^fiF^{f%^Dfr^9^5d, 
I think, produce the fame ^fe#. ^s . : 

In the feed of men, and:i3f other male animals, 
Lewenhoeck, by the help of microfcopes, dif- 
covered an infinite number of animals like tad- 
poles, which he and oth^ers fuppofe to be ,men in 
miniature, and that one of thefe being entered in- 
to an egg in one of the Qvaria (See the next chap- 
ter) conception is perforated. But thpugh fearer 
any one, that has made due enquiry, has ever 

doubted 



tyo URINARY AND GENITAL 

doubted of the exiilence of thefe animals, yet 
there are many who objedl again ft this hypothefis ; 
and though I am inclined to think it true, yet I 
will endeavour impartially to lay down the prin- 
cipal objedions and anfwers, that the reader may 
judge for himfelf. The firft and ftrongeft objec- 
tion, is raifed from the feveral inftances that have 
happened of mixed generation, where the animal 
produced always appears to partake of both kinds, 
as in the common cafe of a mule, which is begot 
by an afs upon a mare j when, according to that 
hypothefis, they expedl the animal produced from 
mixed generation fhould be entirely of the fame 
fpecies with the male animal; as the feeds of 
plants, whatever earth they grow in, always pro- 
duce plants of the fame kind. Neverthelefs if we 
conlider what influence womens fears or longings 
frequently have upon their children in utero, and 
how great a change caftration makes in the £hape 
ofany animal, we cannot then wonder if the 
mother's blood, to which the animal owes its nou- 
rilhment and increafe, from the time of impreg- 
nation to the time of its birth, fhould be thought 
a fufficient caufe of refemblance between thefe 
animals and their mothers. Another objedlion is, 
that nature fhould provide fuch a multiplicity of 
thefe animals, when fo few can ever be of ufe. 
To which it has been anfwered, that in plants a 
very few of the whole that are produced, fall into 
the earth, and produce plants 5 and as in plants 
3 ' the 



PARTS OF MEN. 271 

the greateft part of their feeds are the food of ani- 
mals, fo the greateft part of the animalcute may 
as well live a time to enjoy their own exiftence, 
as any other animal of as low an order. The laft 
objedion is their fhape, which, I think, will 
appear to have no great weight, when we confider 
how the eggs of flies produce maggots, which 
grow up into flies ; and the tadpole produced from 
the egg of a frog, grows into a form as different 
from a tadpole as the form of a man : And if 
thefe animals had produced fo few at a time, as 
that their young might have undergone this change 
in utero, it is highly probable, that we fhould 
not fo much as have fufpccfted thefe analogous 
changes. But how the animalculas themfelves are 
produced, is a difficult queftion, unlefs by equi- 
vocal generation, feeing none of them appear to 
be in a flate of encreafe, but all of a fize. 

In a boy that died of the flone, I found a 
double ureter, each part being dilated to an inch 
diameter 3 the pelvis in each kidney to twice its 
natural bignefs, and the ti\biui^,uriE#r%^^eafihjia^ 
large as the pelvis. ; ^ ^-.»v :.^i >. , : 

In a man that had never been cut for the flone, 
I found the ureters dilated in fome places to fotir 
inches circumference, and in others but little di- 
lated, and a ftone that I found in the bladder was ij 
lefs than a nutmeg, which muft have fallen in 
fcveral pieces, or both ureters could not have been 
dilated, From this, and other like obfervations, 

I think 



^72 GENITAL PARTS OF WOMEM. ^ 

I think it appears that the great fize to which 
the ureters are ufually extended, in people who 
are troubled with the ftone, is owing to fmall 
fiones which fliek at the entrance into the bladder, 
until the obftrudled urine which dilates the ureters, 
can force them into the bladder. 

I HAVE in feveral fubjeds found one kidney al- 
moft confumed, and once a man with but one 
kidney, and I have ken lymphaticks in a difeafed 
tefticle, as large as a crow-quill. 



CHAPTER 11. 

Of the genital parts of women, 

THE external parts are the mons veneris, 
which is that fifing of fat covered with 
hair above the rima magna upon the os pubis, the 
great doubling of the fkin on each {\d,^ the rima 
called labia, and within thefe a lelier doubling 
named nymphs. Thefe help to ciofe up the ori- 
fice of the vagina. The nymphs are ufually faid 
to ferve to defend the labia from the urine ^ but I 
do not fee how the labia fland more in need of 
fuch a defence, than the nymphs themfelves. 

CLITORIS: is a fmall fpongy body bearing 
feme analogy to the penis in men, but has no 
urethra. It begins wich two crura from the offa 
ifchia, which unitbg under the offa pubis, it 
- proceeds 



GENITAL PARTS OF WOMEN. 273 
proceeds to the upper part of the nymphs, where 
it ends under a fmall doubling of iMn, called pr«^ 
putium-, and the end which is thus covered is 
called glans. This is faid'to be the chief feat of 
pleafure in coition, in women, as the glans is ia 
men. 

A LITTLE lower than this, juft within the va- 
gina, is the exit of the meatus urinarius. 

• Vagina is feated between the bladder of 
urine and the inteftinum redum. The texture 
of it is membranous, and its orifice is contraded 
with a fphinder (vid. mufc. fphincftcr vaginge) but 
the farther part is capaciou§.. enough to contain the 
penis without dilating. Near the beginning of 
the vagina, immediately behind the orifice of the 
meatus urinarius, is conftantly found in children, 
a valve called hymen, which, looking towards the 
orifice of the vagina, clofes it 5 but as children 
grow up, and the fphinder vaginse grows ilrong 
enough to contrad and clofe the orifice of the 
vagina, this valve becoming ufclefs, cea-fes to en- 
creafe, and is then known by the name of caruncu- 
lae myrtiformes. There have been a few inftances 
in which the edges of this growing together, it 
continued un perforate, until it hns been necefiary 
to make an incifion to let "Out the menfes. The 
inner part of the vagina is formed into ruga* 
which are largefl in thofe who have not ufed co- 
pulation • and leaft in thofe v/ho have had many 
children. Under thefs rugae are fmall glands, 

S whofe 



274 GENITAL PARTS OF WOMEN. 

whofe excretory duSs are called lacuna?: Thefe 
glands fep.arate a mucilaginous matter to lubricate 
the vagina, erpecially in coition 5 and are the feat 
of a gonorrhcea in this fex, as the glands in the 
urethra are in thie male* 

^ tJtERus is feated at the end of the vaginaj 
It is about one inch thick, two broad, and large 
enough to contain the kernel of a hazel nut ; but 
in women that have had children, a litde larger* 
Its orifice into the vagina is called os tincse, from 
the refeniblance it bears to a tench's mouth. It 
has two round lio-aments which eo from the fides 
of_it\^ jfte groins through the oblique and tranf- 
^erfe mufcks of t|ie abdomen, in the fame man- 
i^er^^is^dp the femif^I^^ yeffels in men. This way 
t1ie^^ut'^^ffes^in_,a^^ inteftinalis in women 

fyjd.^mulci^R^l^domin^ Some authors mention 
iTgamenta lata, wliich are nothing but a part of 
the peritoneum. Near the fides of the uterus lie 
two bodies called ovaria; they are of a deprefled 
oval figure, about half the fize of men's tefiicles, 
and have fpermadc yefiTelsi they contain fmall pel- 
fucid eggs, ^ From which they have their name. 
There are two arteries and two veins, which pafs 
to ^nd^M'om the ovaries or tefies, in the fame 
manner that thev do in men ; but make more 
wihdingSj^'-and" t^\_aTterie^^ dilate more fuddenly, 
""'' "' "" ' Thefe arteries 




the uterus and fal- 
iopTan tubes^ and^noi oW make communications 

betwixt 



(5ENITAL PARTS Oi^ WOMEN. 2f§ 
feetwixt the artery and vein on one fide and thofe 
of the other, but alfo with the proper veffels of the^ 
uterus, which are detached fiom the internal iliac 
arteries and veins. From thefe veflels in the in- 
fide of the uterus, the nientlrual purgations ar© 
made in women, and fonVechlng of the lame kind 
in brutes, as often as they defire coition. One ufs 
of thefe purgations is, to open the veffels of ths 
(iterus, for the veffels of the placenta to join to 
them. Many authors have imagined that there 
mufl be fome evacuations analogous to this^, 
in men, which I cannot fee the neceffity of- but 
on the contrary, I believe that mens not having 
fuch evacuations, is the true reafon why their bo- 
dies grow larger and ftronger than womens : And 
their continuing to grow longer before they are nt 
for marriage, I alfo take to be the true reafoa^ 
why there are more males born than females^ in 
about the proportion of thirteen to twelve j for 
women being; fooner fit for marriap;e than men, 
fewer will die before that time, than of meif; , . 

Near the fides of the ovaria are feated the 
tubsE fallopian^, one end of which is conneded to 
the uterus, and the fi.de to the ovarium by a 
membrane, the other end is loofe, and being jagged 
is called m.orfus diaboli. Among thefe jaggs is a 
fmall orifice which leads Into the tube, which 
near this end is about a quarter of an inch diame* 
ter, and thence, growing gradually finaller, paffea 
(o the uterus, and enters there with an orihce 

S 2 about 



276 GENITAL PARTS OF WOMEN, 
about the fize of a hog's briftle. The ufe of thefe 
tubes is to convey the male feed from the uterus to 
the ovaria, to impregnate the eggs for conceptions} 
yet they appear fo ill adapted to this end, that 
many have fuppofed there muft be fome other 
pailage from the uteriis to the ovaria : But v^hen 
we confider the cafe of conceptions found in thefe 
tubes, and the exad analogy between thefe and 
the tubes of birds, where we have the moft un- 
deniable proofs of the feed going through the 
tube, and of the eggs being impregnated that 
way, and of the eggs coming from the ovarium 
through tKe tube, and feemingly with much great- 
er difficulty than'tn women; and belides, how 
frequently a matter like the male feed (which I 
fuppofe is feed) is found in the fallopian tubes of 
women, as I have found in executed bodies, and 
in a common whore that died fuddenly, it appears 
tome almoft certain, that the feed goes through 
the fallopian tubes to the ovaria to impregnate 
eggs, and comes back through the fame tubes to 
the uterus, I have feen in a woman both the 
fallopian tubes unperforated, which, upon the fore- 
going hypothefis, mud have caufed barrennefs, 
and feed lodged in thefe tubes may have the fame 
efFedl j which I take to be often the cafe of com- 
mon whores, and women that ufe coition too 
frequently ; and perhaps the fut in the membrane 
that conneds the ovaria to tlie tubes, may in very 
fat women fo keep thefe tubes from the ovaria 



GENITAL PARTS OF WOMEN. 277 

as to interrupt impregnations 5 and befides thefe 
cafes, too much or too little of the menfeis rnay 
deftroy or interrupt conceptions; but Jthe ^l^tter 
cafe, efpecially in young women, _i^ ;yer^ ,r,9re. 
From fuch caufes as thefe, and not from imbecil- 
lity, I imagine it is that barrennefs oftener pro- 
ceeds from women than men ; and though women 
do not propagate to fo great an age as men, it is 
not, I believe, for v/ant of being impregnated, 
but from their menfes ceafing, and thofe veflels 
being clofed which fliould nourifh the foetus after 
the impregnation, as if on purpofe to prevent the 
propagation of a feeble and infirm fpecies. And 
from this confideration, one cannot but think that 
the perfedion of the foetus, notwithflanding it is 
firfl: formed in the male feed, depends more upon 

the female than the male, or elfe that' nature 

. - J^rnrno.'- 

would, for the fake of the fpecies, have been care- 



ful to hinder men as well as v/omen from 
gating in a declining age^^^ "^,^^^ ^ 



propc 



83m03 briB \Hgo^ 

no6i 3V£fI I ,dmolu ^dt 

.u3^£'ioli^qnu 33du3 ni:;iqoir£;i- 

^^ ftum .efl^djoqyri gaio^ 

i 3bfb ni bsgbol b^6\ hew. 

.:.d 01 3d£3 1 fl'jidvv^ t fiaii^ 

fxiov/ bnB ^83"iodw, norri 

. I eq^d i3q bn^ ; ^'^^'^P^'^ ^ 

oi £ii£vo o£b zfbornoo iB:h 

S3 " ' CHAPTER 




V :. ( 27^ ) 

...qnaBlhflft^r^PTER III, 
.:5nJ ai sJnr Of the jj^tus in utero. 

%JiE foetus in utero is involved in tvt'o coats^ 
viz» chorion, which is external, andamnioq 
which jmmediatfily indoles the foetus. They con- 
tain a quantily of liquor^ which is a proper nie-r 
dium for fo tender a being as the fcetus to reft in> 
^nd partly fecures it froin external injuries, as the 
aqueoqs humour does the cryftalline in the eye ^ 
and when the membranes burft at the time of 
production, this humour lubricates the vagina 
uteri, to render the birth lefs difficult, i^nd feeing 
the ftomach of a foetus in utero is always full of 
a fluid, lifce what is contained in the amnion, and 
the guts not without excrements ; we may fuppofe 
that this fluid is frequently, during the time of 
geftation, fwallowed by the foetus, if not for nou-=^ 
rifhment, at leaft to keep thefe parts in ufe, and 
tpiiow through the ladpils as a quantity of blood 
fr^ni; c the right ventricle of the heart flow§ 
through the lungs before the birth to keep open 
thofe paffages till the birth, there being after that 
tim.e no other v/ay of receiving nourifhment, 
and that the fiEces found in the guts of a foetus, 
are thofe parts of this fluid that were taken in at 
the mquth, and were too grofs to enter the ladlealso 
Yet I own it takes off very much from the proba- 
bility pf the opimon of the foetus's irnbibing thi^ 

li^uor^ 



FOETUS IN UTERO. 279 
liquor, that, if I am rightly informed, fome who 
have been born with mouths and noftrils unper- 
forate, have had fuch fluids and excrements in the 
inteftines that other foetus's have, which muft be 
confeffedj may be derived from the falivary glands 
and from the liver, &c. The following curious 
paffage was fent me by Mr. Monro. «' This li- 
^' quor contributes nothing to the nouri(hm.ent of 
^' the foetus, for thefe reafons ; firft, becaufe, as 
*' you have well obferved, vaft numbers of in- 
•' fiances might be produced, where no paffage 
*' was to be found for it : I fhall give you one I* 
*' faw myfelf in the Hotel de Dieu at Paris ia 

" Mary Guerlin brought forth two children, 
<* one a complete girl, the other had neither head, 
** neck, arrns, heart, lungs, ftomach, fmall guts, 
*' liver, fpleen, nor pancreas, yet the great guts., 
" the organs of urine and generation of a female, 
*' and lower extremities were perfecft, and of a 
** natural growth ^ the umbilical vein, after enter-^ 
<< ing the abdomen, fplit into a great many branch- 
*' es, which were diftributed to the feveral parts 
" in its abdomen. Though it is true that fooa 
" after conception, the liquor in the amnion, and 
*' that in the ftomach of the fcetus refemble one 
•'another pretty near, yet afterward they differ 
" exceedingly 5 for the liquor in the ftomach is 
** ftill gelatinous, thick, and v/ithout acrimony, 
" while the other becomes thinner and more acrid; 

S 4 *' whereas. 



28o FOETUS IN UTERO. 

** whereas, had the foetus conftantly fwallowed 
" this liquor, the cafe would have been quite op- 
" pofite 5 nay, often it has happened that thefe 
'* waters (as they are commonly called) have been 
** found quite corrupted, ftrongiy fetid, and ex- 
^' tremely {harp, while the fcetus, except the in- 
^^ juries which the external parts received, was 
^' well and found; v/itnefs the example mentioned 
*^ by Bellinger, of a woman who was cured 
^* of a virulent gonorrhoea during her going with 
«' child. And farther by Malpighius's deline- 
*^ ations of the pullus in ovo, it appears to me evi- 
«' dent that the afiteUus ferves the fame purpofe as 
*' the placenta 4^S)fii^i;^iviparous animals, to con- 
*' vey the albumen attenuated by incubation into 
*' the blood-vellels of the chick, and that none of 
*' the albijmen does pafs through the faccus coUi- 
5^ quamenti/* 

Besides thefe coats, in a cow and many other 
animals, w[e find , a membrane called alantois ; it 
is inclofed ])y the chorion together with the am- 
Dion, and contains a quantity of water which it 
receives from the bladder of urine by the urachus. 
Its ufe feems to be to contain the urine that it 
might noj: by the common paffage be emptied in- 
to the liquor of the amnion, of which the fcEtus, 
I am inclined to think, is frequently drinking. 

Wh e t h e^ an alantois is to be found with a hu- 
man fcet;u^ ^^^.anatomiils are not agreed, and 
I canript giye, my opinion^ having never had a 

fiiflicient 



FOETUS IN tlTERb. 281 

fufHcient opportunity to enquire. But furely chil- 
dren having an urachus one cannot well ddiibt of 
an alantqis. I have been informed by a gentlemaii, 
whofe probity I can fuiiiciently rely on, that he 
had feen a child that had no external genital parts, 
and made water through the navel. At Henly 
upon Thames, there is now living a bargeman's 
child about ten years old, of which Iliad' the like 
account ; but upon examination I found the un- 
perforated glans with its fraenum immediately be- 
low the place of the navel, and the urine ilTued 
out by drops between this and the belly, in the 
place which I fuppofe was the navel, but it was 
fb much excoriated, that I could make ii6 cfertain 
judgment about it. In the uterus of a cow with 
two calves, I found they had but one cliorion, 
but each an amnion, and alantois diflind ; but 
the cotyledons, which are analogous to the placenta 
of the human fcetus, were pretty much in com- 
mon to the umbilical blood-vefiels of bofH. c^i^min 
The placenta, or womb-liver,^is(a mfflfe^^bf 
blood veffels feated on the OMtiide df the chorion, 
being compofed of the extreme branches of the 
umbilical vein and arteries, which are for the 
Gompoiition of this part divided into exceeding 
fmall branches to join a like number of the men- 
ftrual veffels of the uterus, which veflels of the 
uterus are m.ade numerous -rather than large,"' that 
the feparation of the placenta from them luay not 
be attended with a fiux of blood fatal to the mo- 
ther^ 



28a FOETUS !NUTERO. 

mother ; for the fides of little veffels foon collapfe 
and clofcj and they are more eafily flopped, being 
compreffed by the uterus itfelf as it {brinks, which 
it begins to do from the time of the birth; but; 
when the placenta is feparated before the delivery, 
whether untimely or not, thefe veffels bleed until 
the uterus is difcharged of the fcetus. The figure 
of the placenta is circular, and at its greateft 
growth about two inches thick, and fix or feyen 
diameter. .^^^^_^j ^t,3f| 

The arteries and veins of the uterus of the mo^ 
ther, by which the menftrual purgations are made, 
are joined to the umbilical arteries and veins in the 
placenta of the fcetus, the arteries of the uterus to 
the veins in the placenta, and the veins in thq 
uterus to the arteries of the placenta :. By thefe 
veffels a large quantity of blood is continually 
flowing from the mother to the foetus and back 
again; but for what end fuch a quantity flows 
continually and back again, I cannot conceive, un-? 
lefs it is that the foetus not breathing for itfelf, it 
is neceffary that as much blood of the mother 
fliould flow continually to the foetus^^ as can leave 
enough of air, or whatever our blood receives in the 
lungs, for the fcetus ; and perhaps what nutritious 
juices the fcetus receives, require a great deal of 
blood to convey them, they being but a fmall 
part of the blood. And though the blood paffes 
fo plentifully between the mother and the fcetus, 
yet the communications are not fo obvious as they 

are 



FOETUS IN UTERO. 283 

^re between the arteries and veins in the fame 
body ; which makes fome think the communica- 
tion is not made by inofculations of vefTels, but that 
the foetus is nouriflied from the placenta in a vege- 
table manner ^ but, I own, I am not of this opi- 
nion. The navel firing or umbilical blood-veflels, 
between the placenta and the navel, are about two 
foot long, that the fostus may have room to move, 
without tearing the placenta from the uterus^ 
which being done too foon, from whatever caufe, 
occafions a mifcarriage. Thcfe vefTels, viz. two 
arteries and one vein, tw^ift about each other, par- 
ticularly the arteries about the vein, and are con- 
tained in one common coat together with a veiTel 
caird urachus, which arifes from the top of the 
bladder of urine, and ends in the membrana allan- 
tois ; the umbilical vein goes from the navel di- 
redly into the liver, and there, enters the great 
trunk of the vena ports. Near which entrance, 
there goes out the dudlus venofus to the great 
trunk of the cava, which carries part of the blood 
that is brought by the umbilical vein, that way 
into the cava, while the reft circulates with the 
blood in the porta, the whole of it not pafling 
through the dudlus venofus, as is generally believed, 
but a great part of it into branches of the porta, 
in the liver, otherwife there need be no commtr- '~^ 
nication between the umbilical vein and the por-^ ; 
ta. When the umbilical vein is flopped, it becomes 
a ligament, and the du(flus veaofos foon fhrinks 

4 and 



284 f^OETUS IN UTERO. 

and almofl difappears, having no longer any blood 
flowing through it ; and even the porta itfelf 
within the liver, from whence only blood could 
pafs after the birth into the duftus venofus, has 
Icfs blood flowing through it for fome time than 
it had before the birth, it receiving much blood 
before the birth from the umbilical vein. The 
Mo^di which flows from the mother to the foetus 
by the umbilical vein, is returned, all but a fmall 
quantity, which is referved for nutrition by the 
two umbilical arteries, which arife from the inter- 
nal iliac arteries, and pafling by the outfides of 
the bladder go diredly to the navel and placenta 5 
thefe with the urachus being ihrunk up after the 
birthji iofe^^m of their appearance, efpecially 
near the «vel, where they are Ipmetimes not to 
be diil:ingiiiilied;o*^' '^^- - • 

Part of the bro(Sd before the birth, and not 
the whole quantity, as is generally thought, which 
is brought by the afcending cava to the right auri- 
cle, pafleslat once through the fDramen ovale into 
the leftuauricle, and the reft flows into the right 
ventricle with the blood of the defcending cava, 
and thence into the pulmonary artery, where about 
one half flows into the lungs, and the other half 
diredly into the aorta by the du6lus arteriofuSa 
which lies between the pulmonary artery, and the 
aorta, which after the birth is called dudus ar- 
teriofus m ligamehtum verfiis. The better to ex- 
plain this contrivance, I: v/ill call the quantity of 

blood 



FOETUS IN UTERO. 285 

blood flowing through the afcending cava in a 
given time, four 5 and that which flows through 
the defcending cava, two : Then let tv^'o of the 
quantity in the afcending cava flow into the right 
auricle, it will then with the two received from 
the defcending cava have the quantity four -, which 
being thrown from the right ventricle into the 
pulmonary artery, the quantity two is thrown into 
the aorta by the dudus arteriofus, and the fame 
quantity into the lungs by the pulmonary bi'anch- 
es ; then the quantity returning from the lungs 
to the left auricle, will be two in the fame given 
time, which being added to the two which flowed 
through the foramen ovale, in the fame time 
there will be conftantly the fame proportions re- 
ceived into each ventricle at every diaflole of the 
ventricles as after the birth. Now if the blood 
flowing through the afcending cava joined by that 
from the umbilical vein, was but equal to that 
flowing through the defcending, let each of them 
be called two, and let all the blood of the afcend- 
ing cava go through the foramen ovale ; then the 
blood which the left ventricle would receive, 
would exceed that which flows into the right, by 
the whole quantity which flows from the lungs 
in the fame time ; but the afcending cava convey- 
ing more blood than the defcending cava, the ex-* 
cefs in the left ventricle would be yet greater. If 
the proportions which I have taken for the eafier 
computing, w^ei'e perfed-Iy right, .riaml. am: fure 

they 



g§6 FOETtJS IN tJTERd 

they are nearly, then the quantity flowing into the 
left ventricle, would be to that flowing into the 
right at the fame time as five to two^ if all the 
afcending blood v/ent through the foramen ovale. 

An 13 though after the birth the left ventricle o( 
the heart is only employed in throwing blood into 
the aorta^ and the right wholly employed in cir- 
culating the blood through the lungs ; yet before 
the birth alt the blood thrown out by the left ven- 
tricle, and about half the blood thrown out of 
the right ventricle^ being thrown into the aorta^ 
and the other part only through the lungs, it fol- 
lows, that the w^hole force exerted by the left 
ventricle^ with about half that of the right, is 
employed in throwing blood into the aorta, while 
that diftributes blood through the whole foetus 
and to the mother : But after the birth^ when the 
blood is to be no longer carried from the foetus 
to the mother, the left ventricle becomes fufficient 
for the circulation through the fcstus, and a new 
occafion immediately afifes for that additional 
power, which before Was necefTarily employed in 
throwing blood into the aorta ; for the whole mafs 
of blood now being to be circulated through the 
lungs, the dudus arteriofus clofes, and the right 
ventricle muft throw all the blood it receives into 
the lungs, there being no longer any paffage into 
the aorta* It is fuppofei that the inflation of the 
lungs at the birthy prefently alters the pofltion of 
tile jduiftos arteiiolUsf ;& as to obilrufl it ^ which 

account 



FOETUS IN UTERO. 287 

account is indeed mechanical, but, I think, not 
true, becaufe I can neither difcern that the pofition 
of this veffel is altered, nor its furface comprefled : 
But I rather think that immediately upon the 
birth, there being no blood carried off from the 
foetus to the mother, and the left ventricle being 
fufRcient to fill the aorta and its branches with 
blood, as I have iTiewn before, there is no longer 
room for any blood from the right ventricle; 
wherefore the blood from the right ventricle will 
be forced into the lungs, where the pafil^ge is 
now made eafy, as I imagine, by their being in- 
flated ', and the dudus arteriofus, having the blood 
no longer forced into it, fhrinks, and in time al- 
moft difappears. This dud being flopped, the 
valve of the foramen ovale foon flops that paflage, 
it being on the fide of the left auricle (or that 
mufcular bag, which is the largefl part of that 
auricle) which being much the flrongefl, the valve 
muft be prefled more on that fide than the other 
by the blood in the time of the fy dole of the au- 
ricle y and it is as evident that in the diaflole of 
the auricle, there mufl be more prefTure to open 
that than the right, it being a ftronger mufcle, 
or elfe there could have been no reafon for 
having the left auricle flronger than the right, in 
proportion to their ventricles. Sometimes this 
valve does not quite cover the foramen, in which 
cafe a fmall quantity of blood may poffibly flow 
from the left auricle to the right^,and fo circulate 

twice 



288 FOETUS IN UTERO. 

twice through the lungs to once through the body^ 
but none could flow from the right to the left and 
efcape the lungs, which might be of bad confe- 
quence. Some have imagined, that men who 
have this paffage open, cannot be drowned : But 
though this paflage is fometimes found open, no 
man has been yet feen, that we have ever heard 
of, that could not be drowned. I have feen the 
foramen open in a man that was hanged, to whom 
one might juftly exped it (hould have been as ufe- 
ful as in the cafe of fubmerlion in water. Many 
writers have fuppofed that this foramen is open in 
amphibious animals, and in fuch fifhes as have 
two auricles, two ventricles, and lungs like land 
animals, without gills, which in other fiih are 
analogous to lungs. I have diffeded a porpus, 
which is of this kind, and found this foramen 
clofed; but the great veins were vafily large in 
proportion to the bulk of the animal ; whence I 
conjedured, their blood w^as accumulated in their 
veins, while they kept under water, and by that 
means the lungs efcaped being opprelTed with 
blood; which conjedture feemed to me the more 
probable, fince all animals of this kind are able to 
abide the leafl time under water, when their blood 
is moft expanded with heat. But upon the dif- 
fedion of an otter, whofe foramen ovale was alfo 
clofed, I found the veins nothing differing from 
thofe of other animals. In a water tortoife which 
I had an opportunity of examining, with that 

moft 



FOETUS IN UTERO. 289 
moft dextrous and indefatigable anatomift Dr. 
Douglass, I found the two ventricles of the 
heart but half divided by a feptum, and in the 
beginning of the pulmonary artery feveral flrong 
mufcular rings, a little diitance from each othet, 
each of which by contracting, would be capable 
ofrefifting a part of that biood, which otherwifs 
would have been thrown into the lungs, when 
they were under water; and this blood fo ob- 
ftruded mufl neceffarily be thrown into the aorta, 
the two ventricles being in a manner one common 
cavity ; and when they are out of the water, this 
communication of ventricles will fuffer but little 
confuiion of the blood which flows into the ven- 
tricles, becaufe each ventricle receiving and dif- 
charging the fame quantity of blood, at the fame 
time, they will balance each other, and thereby 
fuch a mixture will be very much prevented, 
Mr. Monro obferves, that the water tortoife has 
very large lungs, confiiling of larger veficles than 
land animals, and that they receive a greater quan- 
tity of air to furnifli that je ne fcai quoi fo necef- 
fary for the life of animals : The fame thing I 
have obfervcd in frogs. 

As to the reafon of v/omens bringing forth at 
the ufual tim.e ; it has been faid, that at that time, 
the head of the child begins to be fpeciScally hea- 
vier than the reft of the body, and therefore muft 
fall loweft in the fluid it lies in, which being an 
uneafy pofmre, makes the child ftruggle, and 

T bring 



290 OF THE EYE. 

bring on the labour. Bat it is not true, that the 
head then alters its fpecific gravity ; or if it did, 
there is feldom tiaid enough in the amnion for this 
purpofe 'y and befideSj this could only happen right 
in one pofture, and would ufually happen wrong 
in brutes. 



CHAPTER IV. 

Of the eye, 

TH E figure, fituation, and ufe of the eyes? 
together with the eye-brows, eye-laihes^ 
and eye-lids, being well known, I need only de- 
icribe what is ufually fhewn by diffeding. The 
orbit of the eye, or cavity in which it is contained, 
is in all the vacant places filled with a loofe fat, 
which is a proper medium for the eye to refc in, 
and ferves as a focket for it to be moved in. In 
the upper aj:id outer part of the orbit, is feated the 
lacrymal gland. Its ufe is to furniih at all times 
water enough to wafh off duft, and to keep the 
outer furface of the eye moifl, without which 
the tunica cornea would be lefs pellucid, and the 
rays of light would be difturbed in their palTage ; 
and that this liquor may be rightly difpofed of, 
%ve frequently clofe the eye-lids to fpread it equally^ 
even when we are not confcious of doing it. At 
the inner corner of the eye, between the eye-lids, 

ftands 



OF THE EYE. 291 

ftands a caruncle, which feems to be placed to 
keep that corner of the eye- lids from being totally 
clofedj that any tears or gummy matter may flow 
from under the eye-lids, when we fleep, or into 
the punda lacrymalia, which are little holes, one 
in each eye- lid, near this corner, to carry off Into 
the dudus ad nafum, any fuperfluous tears. 

The firft membrane of the eye is called con- 
jundiva; it covers^fo much of the eye as is called 
the white, and being reflecSed all round, it lines 
the two eye-lids ; it being thus returned from the 
eye to the in fide of the eyelids, it efFeiflually hin- 
ders any extraneous bodies from getting behind the 
eye, into the orbit, and fmooths the parts it 
covers, which makes the fridlion left between the 
eye and the eye-lids. This coat is very full of 
blood- veffels, as appears upon any inflammation. 

Tunica Sclerotis, and Cornea, make 
together one firm cafe of a proper form,' for the 
ufe of the other coats and humours. The fore 
part of this ftrong coat being tranfparent, and like 
horn, is called cornea, and the reft fclerotis. Un- 
der the cornea lies the iris, which is an opake 
membrane, like the tunica choroides, but of dif- 
ferent colours in different eyes, fuch as the eye 
appears, as grey, black, or hazel ; for being 
feated under the tunica cornea, it gives fuch an 
appearance to that as it has itfelf. The middle 
of it is perforated for the admiffion of the rays of 
light, and is called the pupil Immediately under 

Tz the 



292 O F T H E E Y E. 

the iris lie the proceffas ciliares, like radial lines 
from a lefler circle to a greater. When thefe pro- 
ceiles contrafl:, they dilate the pupil to fufFermore 
rays of light to enter into the eye ^ and the con- 
trary is done by the circular fibres of the iris, 
which aft as a fphinder mufcle : But thefe changes 
are not made with great quicknefs, as appears 
from the eyes being opprefTed with a firong light 
for fome time, after we come out of a dark place, 
and from the contrary eifedl in going fuddenly 
from a light place to a dark one. And as the pu- 
pil always dilates in darker places, to receive more 
rays of light, fo when any difeafe makes fome of 
thofe rays ineffedual, which pafs through the 
pupil, it dilates as in dark places to admit more 
light ; therefore a dilated pupil is a certain fign of 
a bad eye, and this may be difcerned ufually fooner 
than- the patient difcerns any defed in vifjon. In 
men the pupil is round, which fits them to fee 
every way alike ; it is alfo round in animals that 
are the prey both of birds and beads. But gra- 
minivorous brutes that are too large to be the prey 
of birds, have it oblong horizontally, which fits 
them to view a large fpace upon the earth 5 while 
animals of the cat kind, v/ho climb trees and prey 
indifferently on birds or animals that hide in the 
earth, have their pupils oblong the contrary way, 
which fits them befl to look upward and down- 
ward at once. Befides thefe there are other ani- 
mals whole pupils are in thefe forms, but in lefs 

proportions. 



O F T H E E Y E. 293 

proportions, fo as beft to fit their ways of life. 
Immediately under the fclerotis, is a membrane 
of little firmnefs called choroides. In men it is of 
a rufty dark colour, fuch as will bury almoft all 
the rays of light, that pafs through the tunica re- 
tina, which if it were of a brighter colour^ 
would refledl many of the rays upon the retina, 
and make a fecond image upon the firft fomewhat 
lefs, and lefs diftindl, but both together ftronger ; 
which is the cafe of brutes of prey, where a greac 
part of this coat is perfectly white, which makes 
them fee bodies of all colours in the night better 
than men, for white reflects all colours : But 
brutes that feed only on grafs, have the fame parts 
of this membrane of a bright green, which enables 
them alfo to fee with lefs light, and makes grafs 
an objedt that they can difcern with greateft 
ftrength : But thefe advantages in brutes necefla- 
rily deftroy great accuracy in vifion, which is of 
little or no ufe to them, but to men of great 
confequence. This green part of the tunica cho- 
roides in animals that graze, may properly be 
called membrana uvea, from its refemblance in 
colour to an unripe grape. But in mens eyes 
only a white circle round the back fide of the cho- 
roides near the cornea, is called uvea. 

Immediately under the tunica choroides, 
lies the tunica retina, which is the optic nerve 
expanded and co-extended with the choroides. 
Rays of light flriking upon this ipembrane, the 

T 3 fenfation 



294 OF THE EYE. 

feniation is conveyed by the optic nerves, to the 
common fenforium the brain ; thefe nerves do not 
enter at the middle of the bottom of the eyes, 
but nearer the nofe ; for thc\fe rays of light being 
inefFecSaal for vifion that fall upon the entrance of 
the optic nerves, it is fit they (hould fo enter, as 
that the fame objecft, or part of any object, Ihould 
not be unperceived in both eyes, as would have 
been the cafe, had they been othervi'ife inferted ; 
which appears from a common expermjein of part 
of an objedl being loft to one eye, when- we are 
looking towards it with the other fhat, I know 
a gentleman who having loft one eye by the fmall- 
pox, and going through a hedgfi. a thorn unfeen 
(probably from this caufe) ftiack the other and 
put it. out. The two optick nerves, foon after they 
arife out of the brain, join and feem perfectly 
united ; yet from the following cafe I am not 
without fufpicion of their fibres being preferved 
diftind:, and that the nerve of each eye arifes 
wholly from the oppofite fide of the brain, or 
clfe that the other nerves throughout the body arife 
from the brain, and medulla oblongata, on the 
fides oppofite to thofe they come out of, A fol- 
dier who was my patient in the hofpital about 
fiVQ years fince, had, by a pu(h with a broad 
fword, his left eye raifed in the orbit, v^hich I 
replaced v/ith my fingers ; it was prefently fol- 
lowed with exceffive pain in the right lide of the 
head only ; and a lofs of the fenfe of feeling and 

motion 



OF THE EYE 295 

motion in both the right limbs; the fenfe of feel- 
ing he recovered by degrees in about a month, and 
foon after began to recover their motion, but was 
twelve months before he could walk, and lift up 
his hand to his head 3 and in about two years re- 
covered all but the fight of the wounded eye, 
which indeed did not appear perfed:. In ti(h 
thefe nerves arife difcind: from the oppofite fides 
of the brain, and crofs without uniting; but as 
thefe animals have their eyes fo placed, as not to 
fee the fame object with both eyes at once, where- 
as animals, whofe optic nerves feem to unite, do 
fee the fame objcCt with both eyes at once, one 
would fufped: that in one they were joined to 
make the objedl not appear double, and in the 
other di{iin(5i', to make their two eyes (as they are 
to viev/ different obje<fl:s at the fame time) inde- 
pendent on each other : And yet from the follow- 
ing cafes, the feeing objefts fingle feems not to 
depend upon any fuch union, nor from the light 
ftriking upon correfponding fibres of the nerves, 
as others have believed, but upon a judgment from 
experience, all objedls appearing fingle to both 
eyes in the manner we are mofl ufed to obferve 
them, but in other cafes double ; for though we 
have a diftinft image from each eye fent to. the 
brain, yet while both thefe images are of an ob- 
jed: feen in one and the fame place, we conceive 
of them as one ; fo v/hen one image appears to 
the eyes (when they are diftorted or wrong di- 

T4 reded) 



296 O F T H E E Y E. 

reded) in two different places, it gives the idea of 
two y and when two bodies are feen in one place, 
as two candles rightly placed, through one hole 
in a board, they appear one. But cafes of this 
kind being too numerous, I will conclude v/ith 
one very remarkable, and, I think, much in favour 
of this opinion. A gentleman ^ who fl'om a blow 
on the head, had one eye difcorted, found every 
objedl appear double, but by degrees the moft fa- 
miliar ones became fmgle, and in time, all objeds 
becamx io^ without any amendment of the diilor- 
tion. 

The inlide of the eye is filled with three hu- 
mours, called aqueous, cryflalline, and vitreous* 
The aquecus lies foremoil, and feems chiefly of 
life io prevent the cryftalline from being eafily 
bruifed by rubbing, or a blow : and perhaps it 
fer ves for the cryftalline hum.our to move forward 
io, while we view near objecls^, and backward for 
remoter objeds 5 without which mechanifm, or, 
ixx the place of it, a greater convexity in the cry- 
ftalline humour in the former cafe, and a lefs con- 
vexity in the latter, I do not im.agine, according 
to the laws of optics, how we could fo diftindly fee 
objeds at different dillances, Flowever it is in 
land anim^als, I think, we may plainly fee, that 
fidi move their cryilalline humour nearer the bot- 
tom of the eye when they are out of water, and 
the contrary way in water; becaufe light is lefs 
refraded from water through th,e cryftalline hur 

moor 



O F T H E E Y E. 297 

mOHf than from air. Some have faid, that am- 
phibious animals have a membrane like the mem- 
brana niditans of birds, v^hich ferves them as a 
lens in the water. I have examined the eye of a 
crocodile, which Sir Hans Sloan keeps in fpi- 
rits, and I found this membrane equally thick 
and denfe, and confequently unfit for this pur- 
pofe, or, I believe, any other except that obvious 
one, of defending the eye from the water. Next 
behind the aqueous humour lies the cryftalline ; its 
fhape is a depreffed fpheroid, it is diftinftly con- 
tained in a very fine membrane called aranea. 
The ufe of this humour is to refradt the rays of 
light which pafs through it, fo that each pencil of 
rays from the fame point of any object, may be 
united upon the retina, as in a camera obfcura, 
to make the (Ironger impreffion ; and though by 
this union of the rays, a pidture inverted is made 
upon .the retina, yet furely it is the impulfe only 
of the rays upon the retina, that is the caufe of 
vifion ; for had the colour of the retina been black, 
and confequently unfit to receive fuch a pidure, 
would not the impulfe of hght upon it have been 
fufiicient for vifion ? or would fuch a pidlure, if 
it could have been made without any impulfe, 
have ever conveyed any fenfation to the brain ? 
Then if the impulfe of light upon the retina, and 
not the image upon the retina, is the caufe of vi- 
fion ; when we enquire why an image inverted 
in the eye appears otherwife to the mind, might 

we 



298 O F T H E E Y E. 

we not expea to find the true caufe from confi- 
dering the diredions in which the rays firike the 
retina, as we judge of above and below from a 
like experience, when any thing ftiikes upon any 
part of our bodies ? neverthelefs in viewing an 
object through a lens, we conceive of it as in- 
" verted, whenas in receiving the impulfes of light 
in the fame manner, and having the pidlure on 
the retina in the fame attitude, when we ftand 
on our heads without the lens, we have not 
the fame, but the contrary idea of the pofition of 
the objed. Though I have confidered this hu- 
mour only as a refrador of light, yet the firft and 
greateft refradion is undoubtedly made in the cor- 
nea; but it being concavo-convex, like glaffes of 
that kind, while one fide makes the rays of light 
converge, the other diverges them again. The 
fame thing alfo may be obferved of the aqueous 
humour, Vvhich is indeed more concave than con- 
vex 5 but when the cryftalline humour is removed 
in the couching a catarad, the aqueous polfeffes its 
place and becomes a lens ; but that refrading light 
lefs than the cryftalline, whofe place and fhape it 
partly takes, the patient needs a convex glafs to 
fee accurately. In fome eyes either this humour 
being too convex or too ditlant from the retina, 
the rays unite too foon, unlefs the objed is held 
very near to the eye, which fault is remediable 
by a concave glafs s as the contrary fault, common 
to old perfons,5 ^s by a convex glafs. If the €ye 

had 



O F T H E E Y E. 299 

had been formed for a nearer view, the objefl: 
would often obftrud the lights if it had been 
much farther, light enough would not commonly 
have been produced from the objedl to the eye. 
In fifh the cryftalline humour feems a perfedt 
fphere, which is necefiary for them, becaufe light 
being lefs refracSed from water through the cry- 
ftalline humour than from air, that defedt is com- 
penfated by a more convex lens. The vitreous 
humour lies behind the cryftalline, and fills up the 
greateft part of the eye : Its fore fide is concave 
for the cryftalline humour to lodge in, and its 
back fide being convex, the tunica retina is fpread 
over it j it ferves as a medium to keep the cry- 
ftalline humour and the retina at a due diftance. 

The larger animals having larger eyes, their 
organs of vifion, like a microfcope with a large 
lens, are fit to take in a greater view, but in that 
view things are not fo much magnified; in leffer 
animals a fmall fpace is difcerned, fuch as is their 
fphere of adion, but that greatly magnified, not 
really fo in either cafe, but comparatively, for 
vifion ftiews not the real magnitude of objeds, 
but their proportions one to another. Fifli have 
their eyes, and particularly their pupils, larger 
than land animals, becaufe there is lefs light, and 
that not fo far diftributed in water as in the air. 
In all inflammations in the eye, the utmoft hafte 
fliould be made by bleeding, purging, abftinence^ 
&c. to get rid of the inflammation, becaufe a con- 
tinued 



300 OF THE EYE. 

tinued inflammation feldom fails to make white 
opake fears in the cornea, which caufe dimnefs if 
not blindnefs 5 and no eye- water with powders in 
it fhould ever be put upon the eye, becaufe none 
can be made fine enough. 

An account of obfervatiom made by a young gentle-- 
man who was born blind ^ or left his fight Jo enrly^ 
that he had no remembrance of ever having feen^ 
and was coucUd between thirteen and fourteen 
years of age, 

THO' we fay of this gentleman that he was 
blind, as we do of all people who have ripe 
catarads, yet they are never fo blind from that 
caufe but that they can difcern day from night, 
and for the mod part, in a ftrong light, diftinguifli 
black, white, and fcarlet s but they cannot per- 
ceive the fhape of any thing j for the light by 
which thefe perceptions are made, being let in ob- 
liquely through the aqueous humour, or the ante- 
rior furface of tiie cryftalline, by which the rays 
cannot be brought into a focus upon the retina, 
they can difcern in no other manner, than a found 
eye can through a glafs of broken jelly, where a 
great variety of furfaces fo differently refraft the 
light, that the feveral diftind pencils of rays can- 
not be collected by the eye into their proper foci 5 
wherefore the fhape of an objed in fuch a cafe 
cannot be at all difcerned, though the colour may : 

An4 



O F T H E E Y £• 301 

And thus it was with this young gentleman, who 
though he knew thefe colours afunder in a good 
light, yet when he faw them after he was 
couch'd, the faint ideas he had of them before, 
were not iufiicient for him to know them by after- 
wards, and therefore he did not think them the 
fame which he had before known by thofe names. 
Now fcarlet he thought the moil beautiful of all 
colours, and of others the moft gay were the moft 
pleafing, whereas the firfl: time he faw black it 
gave him great uneafinefs, yet after little time he 
was reconciled to it -, but fome months after, fee- 
ing by accident a negro woman, he w^as ftruck 
with great horror at the fight* 

When he fir ft fav/, he was fo far from mak- 
ing any judgment about diftances, that he thought 
all objects whatever touch'd his eyes (as he ex- 
prefs'd it) as what he felt did his ikin, and thought 
no objects fo agreeable as thofe which were fmooth 
and regular, though he could form no judgment 
of their fhape, or guefs what it was in any objeifl 
that was pleafing to him : He knew not the fhape 
of any thing, nor any one thing from another, 
however different in fhape or magnitude 5 but 
upon being told what things were, whofe form 
he before knew from feeling, he w^ould carefully 
obferve, that he might know them again ; but 
having too many objects to learn at once, he for- 
got many of them ; and (as he faid) at firfl he 
iearn'd to know, and again forgot a thoufand 

things 



302 O F T H E E Y E. 

things in a day. One particular only, though it 
may appear trifling, I will relate : Having often 
forgot which was the cat, and which the dog, he 
was alhamed to afk^ but catching the cat, which 
he knew by feeling, he was obferved to look at 
her ftedfaftly, and then letting her down, faid. 
So pufs, I fhall know you another time. He was 
very much furprized, that thofe things which he 
had liked befl, did not appear moft agreeable to 
his eyes, expedling thofe perfons would appear 
moft beautiful that he loved moft, and fuch things 
to be moft agreeable to his light, that were fo to 
his tafte. We 'thought he foon knev/ what 
pidlures reprefented, which were fhew'd to him, 
but we found afterwards we were miftaken 5 for 
about two months after he was couch'd, he dif- 
covered at once they reprefented folid bodies, when 
to that time he confidered them only as party co- 
loured planes, or furfaces diverfified with variety 
of paint ; but even then he was no lefs furprized, 
expeding the piftures would feel like the things 
they reprefented, and was amaz'd when he found 
thofe parts, which by their light and fhadow ap- 
pear'd now round and uneven, felt only flat like 
the reft, and afk*d which was the lying fenfe, 
feeling, or feeing. 

Being {hewn his father's piflure In a locket at 
his mother's watch, and told what it was, he ac- 
knowledged a likenefs, but was vaftly furprized ; 
aiking, how it could be, that a large face could 
I be 



O F T H E E Y E. ^ 303 

be exprefs'd in (o little room, faying, it fliould 
have feemed as impoflible to him, as to put a 
bufhel of any thing into a pint. 

At firfl, he could bear bat very little fight, 
and the things he faw, he thought extremely large 5 
but upon feeing things larger, thofe Jfirft ken he 
conceived lefs, never being able to imagine any 
lines beyond the bounds he faw; the room he 
was in, he faid, he knew to be but part of the 
houfe, yet he could not conceive that the whole 
houfe could look bigger. Before he was couch'd, 
he expedted little advantage from feeing, worth 
undergoing an operation for, except reading and 
writing ; for he faid, he thoughjt he could have 
no more pleafure in walking abroad than he had 
in the garden, which he could do fafely and rea- 
dily. And even blindnefs, he obferved, had this 
advantage, that he could go any where in the dark, 
much better than thofe who can fee ; and after he 
had feen, he did not foon lofe this quality, nor 
defire a light to go about the houfe in the night. 
He faid, every new objed was a new delight ; and 
the pleafure was {o great, that he wanted words to 
exprefs it j but his gratitude to his operator he 
could not conceal, never feeing him for fome time 
without tears of joy in his eyes, and other marks 
of afFedion : And if he did not happen to come 
at any time when he was expedted, he would be 
fo grieved, that he could not forbear crying at his 
difappointment. A year after firft feeing, being 

carried 



304 O F T H E E A R. 

carried upon Epfom Downs, and obferving a large 
profpedl, he was exceedingly delighted with it, 
and caird it a new kind of feeing. And now be- 
ing lately couch'd of his other eye, he fays, that 
objects at firft appear'd large to this eye, but not 
fo large as they did at firft to the other ^ and look- 
ing upon the fame objed: with both eyes, he 
thought it look'd about twiq^ as large as with the 
firft couch'd eye only, but not double, that we 
can any ways difcover. 

I HAVE couched feveral others who were born 
blind, whofe obfervations were of the fame kind ; 
but they being younger, none of them gave fo 
full an account as this gentleman. 



CHAPTER V, 

Of the ear, 

THE figure and fituation of the outer ear 
needs no defcription : Its inner fubftance is 
cartilage, which preferves its form without being 
liable to break : Its ufc is to colled: founds, and di- 
reft them into the meatus auditorius, which is the 
paflige that leads to the drum ; this pafTage is lined 
with a glandular membrane, in which alfo is fome 
hair; the cerumen which is feparated by thefe 
glands, being fpread all over this membrane, and its 
hairs, ferve to defend the membrane from the 

outer 



O F T H E E A R. 3^5 

outer air, and to entangle any infed that might 
otherwife get into the ear. Sometimes this wax be- 
ing feparated in too great quantity, it fills up the 
paflage and caufes deafnefs ; and thofe great dif- 
charges of matter from the meatus auditorius, 
which are commonly called impofthumes in the ear, 
1 think, can be nothing elfe than ulcerations, or 
great fecretions from thefe glands. At the farther 
end of the meatus auditorius lies the membrana tym- 
pani, which is extended upon a bony ridge almoft 
circular : Its fituation in men and brutes is nearly 
horizontal, inclined towards the meatus auditorius, 
which is the befl: pofition to receive founds; a great 
part of them being ordinarily reverberated from 
the earth. In men and brutes it is concave out- 
ward, but in birds it is convex outward, fo as to 
make the upper fide of it nearly perpendicular to the 
horizon, which feems fitter to hear each other's 
founds when they are high in the air, where they 
can receive but little reverberated found. This 
membrane does not entirely clofe the paflage, but 
has on one fide a fmall aperture covered with a 
valve. I found it once half open in a m.an that I 
diflecled, who had not been deaf; and I have fetn 
a man fmoak a whole pipe of tobacco out through 
Jus ears, which muft go from the month through 
the euftachian tube, and through the tympanum ; 
yet this man heard perfeflly well. Thefe cafes oc- 
cafioned me to break the tympanum in both ears 
of a dog, and it did not deftroy his hearing, but for 

U fome 



3o6 O F T H E E A R. 

fooie time he received ftrong founds with great 
horror. Mr. St. Andre has aflured me that a 
patient of his had the tympanum deftroyed by an 
ulcer, and the auditory bones cafl out, without de- 
flroying his hearing. From thefe and other Hke 
cafes, may be concluded that the membrana tym- 
pani, though ufeful in hearing, is not the feat of 
that fenfe, and if any difeafe in that membrane 
ihould obftrudl the paflage of founds to the inter- 
nal parts of the ear, which are the feat of that 
fenfe, an artificial paflage through that membrane 
might recover hearing, as the removing the cryftal- 
line humour, when that obflruds the light, reco- 
vers fight. Some years fince a malefador was par- 
doned on condition that he fuffered this experiment, 
but he falling ill of a fever the operation was de- 
ferred, during which time there was fo great a 
public clamor raifed againfl it that it was afterwards 
thought fit to be forbid. In very young children 
1 have always found this membrane covered with 
mucus, W'hich feem^s neceflTary to prevent founds 
from affi^ding them too much, there being no pro- 
?i(ion to fliut the ears, as there is for the eyes. A 
gtntlempai well known in this city, having had 
tour children born deaf, was advifed to lay blifters 
upon the heads of the next children he might have, 
which he did to three which were born afterward, 
and every one of them heard well. It feem.s not 
unreafonable to fuppofe that too great a quantity of 
this mucus upon the drum might be the caufe df 
3 deafnefs 



O F T H E E A R. 3Q7 

deafnefs in the four children, and that the difcharge 
made by the blifters in the latter cafes was the 
caufe of their efcaping the fame misfortune. 

Into the middle of the tympanum is extended 
a fmall bone called malleus, whofe other end is 
articulated to a bone called incus, which is alfo ar- 
ticulated by the intervention of an exceeding fmall 
one, called orbiculare, to a fourth bone called {ta- 
pes. Thefe bones are contained in that cavity Be-^ 
hind the tympanum, which is called the barrelof 
the ear; but fome anatomift's^call the barrel only 
tympanum, and the membrane membraria tympa- 
ni. The malleus being moved inward by the muf- 
culus obliquus internus, or trochlearis^ it extends 
the tympanum that it may be the more afFejfled by 
impulfe of founds when they are too weak"^.' I^f^^s 
mufcle arifes from the cartilaginous part of. the eii- 
ftachian tube, and paffing from thence in a proper 
groove, it is reflected under a fmall procefs, and 
thence paffes on perpendicular to _ the tympanum 
to be inferted into the handle of the malleus, 
fometimes with a double tendon. Parallel to this 
mufcle lies another extenfor of the tympanum, 
called obliquus externus; it arifes from the outer 
and upper part of the euilachian tube, and paffing 
through the fame hole with the corda tympanr, 
which is a branch of the fifth pair of nerves, it is 
inferted into a long procefs of the malleus : This 
is not fo obvioufly an extenfor ds t6 t)e known 
to be fo without an experiment. The mufcle 

U z which 



3o8 O F T H E E A R. 

which relaxes this membrane is called externus 
tympani 5 it arifes from the upper part of the au- 
ditory paffage under the membrane which lines, 
that paffage, and is inferted into the upper procefs 
of the malleus. The relaxation of the tympanum 
is made by this mufcle, without our knowledge, 
when founds are too ftrong ; and as the pupil of 
the eye is contraded when we have too much 
light, and dilated where there is too little, from 
what caufe foever, fo when founds are too low, 
or the fenfe of hearing imperfed, from whatever 
Ciiufe, the extenfors of the tympanum ftretch it to 
make the impulfe of founds more effedual upon 
it, jull as in the cafe of the common drum, and 
the cords of any mufical inftrument. From the 
cavity behind the tympanum, which is called the 
barrel of the ear, goes the euftachian tube, or 
iter ad palatum ; it ends cartilaginous behind the 
palate. This paffage feems to be exaftly of the 
iame ufe with the hole in the fide of the common 
drum, that is to let the air pafs in and out from 
the barrel of the ear to make the membrane vibrate 
the better, and perhaps in the ear, which is clofer 
than a common drum, to let air in or out as 
it alters in denfity, and if any fluid fhould be fe- 
pa rated in the barrel of the ear, to give it a 
paffage out. This paffage being obftrudled, as it is 
fometimeSj by a large polypus behind the uvula, 
it caufes great difficulty of hearing, and fometimes, 
when the meatus auditorius is obffru<ited, a man 

opening 



O F T H E E A R. 309 

opening his mouth wide, will hear pretty well 
. through this paffage, which is often fo open, as 
that fyringing water through the nofe, it fliall pafs 
through into the barrel of the ear and caufe deaf- 
nefs for fome time. If any one would try how 
he can hear this way, let him flop his ears, and 
take between his teeth the end of a wire, or cord 
that will vibrate well, and holding the other end, 
ftrike it, and the found that he hears will be 
through this paflage. To the ftapes there is one 
mufcle called mufculus ftapedis ; it lies in a long 
channel, and ending in the ftapes, it ferves to^pull 
the ftapes off of the feneftra ovalis, which other- 
wife it covers. Befides the feneftra ovalis, there 
is another near it fome what lefs, called rotunda ; 
thefe two holes lead to a cavity called veftibulum, 
which leads into other cavities aptly called cochlea, 
and three femicircular canals, or altogether the 
labyrinth, in which are fpread the auditory nerves, 
to receive, and convey the impulfe of founds to 
the common fenforium the brain ; and furely the 
chorda tympani, which is a branch of the fifth 
pair q( nerves, may alfo convey thefe fenfations 
to the brain. The two holes, called feneftra ovalis 
& rotunda, are clofed with a fine membrane like the 
membrane called the drum, and the larger being 
occafionally covered and uncovered by the ftapes, 
founds are thereby made to influence more or lefs, as 
beft ferves for hearing ; and this advantage being 
added to that of a lax or tenfe tympanum, the efFe<fl of 

U 3 founds 



310 SENSES OF SMELLING, 

founds may be greatly encreafed or leffened upo» 
the auditory nerves, expanded in the labyrinth. 
In the flrongeft founds, the tympanum may be lax, 
and the feneftra ovalis covered, and for the loweft, 
the tympanum ienih and the feneftra uncovered. 
If founds propagated in the air were heard lefs, 
we might often be in danger before we were ap- 
prized of it ; and if the organs of hearing were 
much more perfefl:, unlefs our underftandings were 
fo too, we ftiould commonly hear more things ajt 
once than we could attend to. 



C H A P T E R VI. 

Of the fenfes of jmelling^ ^^f^^gy and feeling. 

THE fenfe of fmelling is made by the effluvia, 
which are conveyed by the air to the nerves, 
ending in the membranes which line the nofe and 
its lamells. In men thefe lamellas are few, and 
the paffage through the nofe not difficult ^ hence 
fewer effluvia will ftrike the nerves, than in ani- 
mals of more exquifite fmell, whofe nofes being 
full of lamella, and the paffage for the air narrow 
and crooked, few of the effluvia efcape one place 
or another; befides, their olfadory nerves may be 
more fenfible. Fifli, though they have no nofes, 
yet in their mouths they may tafte effluvia in the 
water, as furely thofe ^lih do, who feek their prey 

in 



TASTING, AND FEELING. 311 

in the darkeft nights, and in great depths of water, 
there being more nerves difpofed in their mouths, 
than through their whole bodies befide, the optic 
excepted; and it feems as if it was done for this 
purpofe ; for the mere fenfe of tailing is ordina- 
rily lefs curious in them, than in land animals ; 
in baiting eel-balkets, if the bait has lam long in 
water, it is feldom followed ; but upon fcarifying 
it afrefli, which will make it emit new effluvia, 
it ferves as a frefh bait. The fenfe of tailing is 
made in the like manner upon the nerves which 
line the mouth, as is that of feeling upon the nerves 
diftributed throughout the body ; of which I 
fhould fpeak more in this place, if I had not done 
it already m the chapter of the nerves. 



U4 TABLE 



( 3^2 ) 

TAB. XXXI. 

t The under fide of the bladder. 

2 The ureters. 

3 Vafa deferentia. 

4 Veiicols feminales. 

5 The proflate gland. 

6 Meatus urinarins. 

7 A tranfverfe fedion of the corpora cavernofa 

penis. 

8 Corpus cavernofum urethra?. 

9 Urethra. 

i o Septum penis, 

ii The feptum between the corpus cavernofuni 
urethra, and that of the penis. 

12 The corpora cavernofa penis divided by the 

feptum. 

1 3 Corpus cavernofum glandis. 



TAB. XXXII. 



T.AB.XXXI 




P.312. 



^V3- 




( 313 ) 

1. 

TAB. XXXII. 

1 That fide of the uterus which is next the gut, 

2 The fallopian tubes. 

3 The fimbriae. 

4 Ovaria. 

5 The mouth of the uterus. 

6 Ligamenta rotunda. 

7 The infideofthe vagina, 

8 The orifice of the meatus urinarius. 
The glans clitoridis. 

The external labia of the vagina. I 

The nymphae which are continued from the 

praeputium clitoridis. 



TAB. XXXIII. 



( 3H ) 

TAB. XXXIIL 

The parts of an hermaphrodite negro, which was 

neither fex perfed'^ bu'^ a wonderful mixture 

of both. This perfon was twenty-fix years of 

age, and in fhape perfedly male. 

I A clitoris, when ereded, almoft as large as a 

penis. 
^ The glans of the clitoris, 

3 Labia, or a divided fcrotum ; in which were 

perfed tefticles with all the veffels. 

4 Nymphse. 

5 The entrance into the vagina^ where were ca- 

runculae myrtiformes. 

6 Furca Virginia. 

The lower figure reprefents another her- 
maphrodite, whofe ihape was rather fe- 
male than male, but too young to have 
female breafts, or a beard, like a male, 
upon the face. 

7 The glans clitoridis. 
S Nymphae. 

g Labia with tefticles in them, divaricated to 
fliew the parts between, but in their natu« 
ral fituation very like the other, as the 
other when divaricated refembled this. 

io The entrance into the vagina, 

1 1 Furca virginis. 

TAB. XXXIV. 



TAB.xxxrn. 



P-3f^- 




PV3^ 




f 



(3^5 ) 

TAB. XXXIV, 

J The right yentricle of a fcetus diftcnded witH 
wax. 

t The right auricle. 

3 The left auricle. 

4 Branches of the pulmonary veins of the right 

lobe of the lungs, thofe of the left being 
cut off fhort. 

5 The arteries of the left lobe of (he lungs. 

6 The vena cava defcendens. 

7 Aorta afcendens. 

8 Arteria pulmonalis. 

9 Dudus arteriofus. 

JO The under fide of a heart of a younger fgetui. 

1 1 The right auricle cut open. 

1 2 The cava defcendens cut open. 

13 Tuberculum Loweri. 

14 The foramen ovale clofed with its valve. 

15 The mouth of the coronary veins. 

1 6 The umbilical vein. 

17 Branches of the vena porta in the livery 

18 Dudus venofus^ 

1 9 Branches of the cava ia the liver, 
ZQ Vena cava. 



TAB. XXXV. 



;{3l6j) 

TAB. XXXV, 

1 A crofs for an.objedt. 

2 The objed: reprefented on the retina at the bot- 

tom of each eye. 

3 The entrance of the optic nerves in whif^h pl^cc 

.no objed is reprefented. 

4 Cones within which all objeds plac*d are dark 

to each eye, the rays from thence falling 
upon the entrance of the optic nerves, but 
that which falls upon the entrance of the 
optic nerve in one eye^ can neyer fall upon 
the optic nerve in the other, 

5 Pencils of rays from points of the objed pafT- 

ing through the cryftalline humour, where 
they converge, to meet in a point op 
the retina to formvifion. 



TAB. XXXVI 



i_^^.XXXV. 



/?:?/; 



g^!.:;:■^:||pllln'!l":.|^^^||..MvM.|l:>^!:i0^i.M»;l■!»!^:TT^^M.^;.».lllil;il imiiiwiiiiii! iiinii;M:.i^i;ii^^|i;iji!!ii;M|iiii:yiiiii,:ii.»;i;mi'inMM:i' 



/I 



%3 






Hi ^ % 



iMmm 


















^ / ®^ 






m h 

iS // 




^ 






\I 



■■ \M;. 




TAB.XXXVI. 



7? 3/7. 





( 3^7 ) 

TAB. XXXVI. 

2 A knife pafs*d through the tunica fclerotis, un- 
der the cornea before the iris, in order to cat 
an artificial pupil where the natural one is 
clos'd. This operation I have performed feve- 
ral times with good fuccefs j indeed it cannot 
fail when the operation is well done, and 
the eye no otherwife difcas'd, which is more 
than can be faid for couching a catarat^. In 
this operation great care mufl be taken to 
hold open the eyelids without preffing upon 
the eye, for if the aqueous humour is fqueez'd 
out before the inciiion is made in the iris, 
the eye grows flaccid^ and renders the ope- 
ration difficult. 

2 A crooked needle pafs'd through a proptofis 
of the cornea ; the black line in the cornea 
inclofes the piece to be cut out with a knife* 
The operation being thus done, the cryftalline 
humour immediately falls out ^ and in a few 
days the lips of the wound unite. This ope^ 
ration is very ufefal, and attended with but 
little pain. I have done the fame thing 
when the whole eye has been fo enlarged that 
the eyelids could not be clofed, which has 
funk the eye in the head ; but this operation 
was attended with fuch violent pain that I 
cannot much recommend it, 

3 Shews 



(3i8) 

Shews how an opake fear upon the cornea^ 
by obftrufting part of each pencil of rays, 
makes a dimnefs of fight without a total 
lofs. 

Shews how a cataradl or obftrudion of the 
cryftalline humour, will obftrudl the light 
which is before it. And how fome fide 
light may pafs to the retina through the aque- 
ous humour, but not being brought into a 
focus gives only a fenfe of light without vi- 
lion. 



TAB. XXXVII. 



T^Bxxxvn. 



P.^ip. 







( 3^9 ) 
TAB. XXXVII. 

1 A bone taken out from the firft procefi of tb^ 

dura mater not far from the crifta galli. 

2 A bone taken out of the mufcular part of the 

heart of a man. 

3 The under fide of a bone taken out of a frac- 

tured fkull. 

4 The upper fide of a bone from the fame fkull, 

where the operation of the trepan had been 
thrice made. This girl was brought into 
the hofpital a week after the accident. I im- 
mediately open'd the fcalp, and let out about 
two ounces of grumous blood, and laid the 
fcull bare about four inches one way, and 
three the other, and tied the blood-vefTels, 
that I might make the operation v/ithout 
much difficulty foon after. The fradturc 
extended acrofs the os bregmatis from the 
fagittal future to the temporal bone ; that 
part next the os frontis was deprefs'd equal 
to its thicknefs, and a great deal of extrava- 
fated blood, and fome matter lay under the 
other part of the fame bone. I made two 
perforations with the trephine, clofe to the 
frafture, that I might raife it up fleddily 
through both, and have more room for the 
extravafated blood to difcharge from under 
the fkull, which had difcharged before hi 
great quantity through the fradure. But 

never- 



( 320 ) 

neverthelefs ten days after the former opera- 
tion I was obliged to make another perfora- 
tion to difcharge the matter more freely; for, 
during a month, the matter ran through all 
her dreflings down her face twice every day, 
and was exceedingly fetid, and for the fpace 
of three months the matter decreased very lit- 
tle in quantity, but grew lefs and lefs ofFeniive. 
September the thirteenth, the leaft of the 
bones was taken out ; and on September the 
twenty-ninth, the large one; after which 
time the matter was good, and not too much 
in quantity. Each of thefe bones is through 
both tables, for the motion in the brain was 
feen, only fome little parts of the leffer bone 
remaining, a callus was formed from them ; 
but where the great one came away there 
was no callus, only a common cicatrix ; and 
befides thefe, many little bits of bone 
came away in the dreffings : She was 
foon after cur*d, and has remained well many 
?ears. 



TAB. XXXVIIL 



TAB. XXXVIII 




2:2. 



(321 ) 

TAB. XXXVIII. 

The figure of Samuej. Wood a miller, whofe 
arm, with the fcapula was torn off from his 
. body, by a rope winding round it, the other 
end being faften'd to the coggs of a mill. 
This happen'd in the year 1737. The vef- 
fels being thus ftretch'd bled very little, the 
arteries and nerves were drawn out of the 
arm ; the furgeon who was firfl call'd 
placed them within the wound, and drelTed it 
fuperficially. The next day he was put un- 
, der Mr. Ferne's care, at St. Thomas's hof- 
pital, but he did not remove the dreffings 
for fome days : The patient had no fevere 
fymptoms, and the wound was cur'd by 
fuperficial dreffings only, the natural fkin be- 
ing left almoft fufficient to cover it ^ which 
fhould in all cafes be done as much as may be t 
Above twenty years fince I introduc'd the me- 
thod of amputating, by firft dividing the fkin 
and membrana adipofa, lower than the place 
where the operation was to be finifr/d, the ad- 
vantages of which are now fufRciently known* 

1 The end of the clavicle. 

2 The cicatrix, 

3 The fubfcapularis mufcle. 

4 The cubit broke in two places. 

X TAB. XXXIX. 



( 322 ) 

TAB. XXXIX. 

Represents the cafe of John Heysham^ 
who, the fiiday before Eafter, in the year 
172 1, by over-flraining himfelf at work^ 
had a rupture of the inteftines into the fcro- 
tum, which could by no means be reduced. 
He was brought iuto St. Thomas's hofpital 
the monday following, and I would have 
performed the operation immediately, but he 
refufing to fubmit, it was deferred till tuef- 
day morning, when he being willing, I per-- 
formed the operation, and making a large 
wound in the bottom of the abdomen, the 
inteftines were eafily reduced, and near a 
quart of water v/as difcharged out of the 
fcrotum at the fime time. There had been 
a rupture of the omentum before, which be- 
ing united to the fcrotum and fpermatic vef- 
fels, I paffed a needle with a double ligature 
(as is expreffed in the plate) under that part 
of the omentum that adhered, fo as not to 
hurt the fpermatic vefiels; then cutting out 
the needle, I tied one of the firings over the 
upper part of the omentum, and the other 
over the' lower, and then cut off as much of 
it as was in the way. My reafon for tying 
in this manner was to fecure the blood-vef- 
fels, which, I think, could not be done fo 
well with one ligature, becaufe of the large- 

nefs 



TAB .XXXIX. 



P. -322. 




( 323 ) 

nefs of the adhefion and the texture of the 
omentum, v/hich renders it too liable to be 
torn by fuch a bandage. Three days after 
the operation an erifipylas begun in his legs, 
and fpread all over his body, the cuticle every 
where peeling off; yet he recovered, and con- 
tinues in a good ftate of health. After he 
was cured, at firft he wore a fmall trufs, 
but left it off in a (hort time, and now feels 
no inconvenience from it, though he lives 
by hard labour. 



Xz TAB. XL. 



( 324 ) 

TAB. XL. 

The cafe of Margaret White, the wife 
of John White, a penfioner in the fifhmong- 
ers alms-houfes at Newington in Surry. In 
the fiftieth year of her age, fhe had a rupture 
at her navel, which continued till her feven- 
ty third year, when after a fit of the cholic, 
it mortified, and fhe being prefently after ta- 
ken with a vomiting, it burft. I went to 
her and found her in this condition, with 
about fix and twenty inches and an half of 
the^at hanging out mortified, I took away 
what was mortified, and left the end of the 
found gut hanging out at the navel, to which 
it afterwards adhered; fiie recovered, and 
lived many years after, voiding the ex- 
crements through the intefi:ine at the nave], 
and though the ulcer was fo large, after the 
mortification feparated, that the breadth of 
two guts was (cen ; yet they never at any 
time protruded out at the wound, though 
fhe was taken out of her bed^ and fat up 
every day. 

1 The gut. 

2 The cicatrix of the wound. 



CH AP^ 



TAB.XL 



P-324. 




( 325 ) 

C H A P T E R VI. 

AJJdort hijlorical account of cutting jor the Jf one, 

TH E mofl ancient way of cutting for the 
ftone is that defcribed by Celsus, which 
was indeed cutting upon the gripe, but in a very 
different manner from that operation in later ages, 
for he diredls a lunated incifion with the horns 
towards the coccyges, which was plainly that the 
gut might be preffed downwards to avoid wound- 
ing it, and then a tranfverfe incifion upon the 
ftone might be made fafely, but not in very young 
children, for want of room, nor after puberty, 
for then the proftats are too large to allow of 
this operation ; therefore they did not ufually cut 
any younger than nine years, nor older than four- 
teen: Afterwards, but when we know not, this 
operation was improved by cutting lower, and on 
one fide, which is the operation now called cut- 
ting on the gripe, or with the leflTer apparatus. 

In the year 1524, Marianus publiihed the 
method of cutting by the greater apparatus, now 
commonly calFd the old way, but he owns it was 
invented by his Mafier Johannes de Romanis. 

In the year 1697, Frere Jacques came to 
Paris, full of reputation for the fuccefs of his new 
operation for the ftone ; he foon obtain'd leave to 
cut in the hofpitals, where great numbers of his 

X 3 patients 



«, 



326 CUTTING FOR THE STONE. 

patients dying, and being diffecfted, they were 
found with their bladders cut through, guts 
v/ounded, &c. which brought the operation into 
difgrace, as Mery andDioNis have related, who 
law thefe things. They fay he performed the ope- 
ration without any diredlion, and without any 
knowledge of the parts he was to cut, a thing not 
to be mentioned without horror : But of late his 
character has been fet in a very different light, 
and though 'tis more than probable he himfelf 
knew not what he did, yet there are now, vvho 
pretend to tell us exactly, though if their teftimonies 
are to be regarded, v/ho faw him operate, there is 
no place that he did not cut one time or other, and 
therefore he may have a fort of right to be call'd 
the inventor of any operation for the ftone that can 
ever be performed in thefe parts. It is alfo own'd 
that he fometimes had great fuccefs, which was 
enough to put others of that nation upon trying of 
it in a more judicious manner 5 but if there were 
fuch, failing of fuccefs, they have conceaFd their 
experiments. 

Mr. Rau of Amfterdam, who faw F. Jacques 
operate, profefs'd to do his operation with the ne- 
cefTary improvement of a grooved ftaff, which if 
Jacqjjes ever ufed, he furely learned that of 
Rau. He fucceeded wonderfully, and if he, who 
was an excellent anatomift, may be allow'd to 
iinderftand his own oper;ation, it was diredly into 
tk^ bladder j> without wounding either the urethra 

9¥ 



CUTTING FOR THE STONE. 327 
or the proftates : befides this, other competent 
judges^ who were witneiTes to his operations, have 
bore the fame teftimony. 

In the year 1717-18, Dodor James Doug- 
lass, in a paper prefented to the Royal Society, 
demonflrated from the anatomy of the parts, that 
the high operation for the ftone might be pradti- 
fed ; which had been once performed by Franco 
injadicioufly, and by him difrecommended, though 
his patient recovered ; and afterwards ftrongly re- 
commended, but not pradifed by Ross et. Yet 
no one undertook it, till his Brother Mr. John 
Douglass, about three years after, performed it, 
and with great appkufe, his two firft patients re- 
covering. Soon after a Surgeon of St. Thomas's 
hofpital cut two, who both recovered 3 but the 
fame gentleman afterwards cutting two, who mif- 
carried by the cutting or burfting the peritone- 
um, fo that the guts appeared, this way imme- 
diately became as much decryed as it was before 
commended ; upon which the furgeons of St. Bar- 
tholomew's hofpital, who had prepared to perform 
this operation, altered their refolution, and went on 
in the old way. The next feafon, it being my 
turn in St. Thomas's, I refumed the high way, 
and cutting nine with fuccefs, it came again in 
vogue 5 after that every lithotomift of both hof- 
pitals pradifed it 3 but the peritoneum being 
often cut or burfl, twice in my pradice, though 
fome of thefe recovered, ^nd ibmetimes the 

X 4 * bladder 



328 CUTTING FOR THE STONE. 

bladder itfelf was burft, from injeding too much 
water, which generally proved fatal in a day or 
two. Another inconvenience attended every ope- 
ration of this kind, which was, that the urine's 
lying continually in the wound, retarded the cure, 
but then it was never followed with an inconti*. 
nence of urine. What the fuccefs of the feveral 
operators was, I will not take the liberty to pub- 
!i(h 5 but for my ovi^n, exclufive of the two before 
mentioned, I lofl no more than one in feven, 
which is more than any one elfe that I know of 
could fay ; whereas in the old way, even at Paris, 
from a fair calculation of above 800 patients, it 
appears that near two in five died. And though 
this operation came into univerfal difcredit, I muft 
declare it my opinion, that it is much better 
than the old way, to which they all returned, ex- 
cept myfelf, who would not have left the high 
way but for the hopes I had of a better, being 
well aiTured that it might hereafter be pracftifed 
with greater fuccefs ; thefe fatal accidents having 
pretty well fliewn hov/ much water might be in- 
jeded, and how large the wound might fafely be 
made. But hearing of the great fuccefs of Mr. 
Rau, profeiTor of anatomy at Ley den, I deter- 
mined to try, though not in his manner, to cut 
diredly into the bladder 5 and as his operation was 
an improvement of Friar Jacques, I endeavoured 
to improve upon him by filling the bladder, as 
Douglass had done in the high way, with water, 
I leaving 



CUTTING FOR THE STONE. 329 

leaving the catheter in, and then cutting on the 
outfide of the catheter into the bladder, in the 
fame place as upon the gripe, which I could do 
very readily, and take out a frone of any fize w^ith 
more eafe than in any other way. My patients 
for fome days after the operation feemed out of 
danger, but the urine which came out of the 
bladder continually lodging upon the cellular 
membrane on the outfide of the reftum, made 
foetid ulcers, attended with a vaft difcharge of 
ftinking matter, and from this caufe I loft four 
patients out of ten. The cafe of one which efcaped 
was very remarkable ; a few days after he was 
cut, he was feized with a great pain in his back 
and legs, with very little power to move them ; 
upon which he turned upon his face, and refled 
almoft conilantly upon his knees and elbows above 
a fortnight together, having no eafe in any other 
pofture all that while ; at length his urine coming 
all the right way, his wound foon healed, and he 
recovered the ufe of his back and limbs, I think 
all thefe fevere fymptoms could proceed from no 
other caufe than the urine and matter fomehow 
offending the great nerves 3 which come out of 
the OS facrum to go to the lower limbs. I then 
tried to cut into the bladder, in the fame 'manner 
that Mr. Rau was commonly reported to do, 
but there had the fame inconvenience from the 
urine's lodging upon the cellular membrance on the 
outfide of the inteftinum redum. Upon thefe 

difap- 



330 CUTTING FOR THE STONE. 

difappointments, I contrived the manner of cut- 
ting, which is now called the lateral way. This 
operation I do in the following manner : I tie the 
patient as for the greater apparatus, but lay him 
upon a blanket feveral doubles upon an horizontal 
table three foot high, with his head only raifed* 
I firft make as long an incifion as I can, beginning 
near the place where the old operation ends, and 
cutting down between the mufculus accelerator 
urins, and ereftor penis, and by the fide of the 
inteftinum redum : I then feel for the ftaff, 
holding down the gut all the while with one Or 
two fingers of my left hand, and cut upon it 
in that part of the urethra which lies beyond 
the corpora cavernofa orethrs, and in the pro- 
ftate gland, cutting from below upwards, to 
avoid wounding the gut 3 and then paffing the 
gorget very carefully in the groove of the ftafF 
into the bladder, bear the point of the gorget 
hard againft the ftaff, obferving all the while that 
they do not feparate, and let the gorget flip to the 
outfide of the bladder; then I pafs the forceps 
into the right fide of the bladder, the wound be- 
ing on the left fide of the perinsum ; and as they 
pafs, carefully attend to their entering the blad- 
der, which is known by their overcoming a ftrait- 
nefs which there will be in the place of the wound ; 
then taking care to pufh them no further, that 
the bladder may not be hurt, I firft feel for the 
ftone with the end of them., which having felt^ 

I open 



CUTTING FOR THE STONE. 331 

I open the forceps and fiide one blade underneath 
it, and the other at top 5 and if I apprehend the 
ftone is not in the right place of the forceps, I 
fhift it before I offer to ex trad:, and then extradl 
it very deliberately, that it may not flip fuddenly 
out of the forceps, and that the parts of the 
wound may have time to flretch, taking great 
care not to gripe it fo hard as to break it, and if 
I find the ftone very large, I again cut upon it as 
it is held in the forceps. Here I muft take notice, 
it is very convenient to have the bladder empty ' 
of urine before the operation, for if there is any 
quantity to flow out of the bladder at the pafling 
in of the gorget, the bladder does not contrad: 
but collapfe into folds, which makes it difficult 
to lay hold of the ftone without hurting the blad- 
der 3 but if the bladder is contracted, it is fo eafy 
to lay hold of it, that I have never been delayed 
one moment, unlefs the ftone was very fmall. 
Laftly, I tie the blood-veflels by the help of a 
crooked needle, and ufe no other dreffing than a 
little bit of lint befmear'd with blood that it may 
not ftick too long in the wound, and all the dref- 
fings during the cure are very flight, almoft fuper- 
ficial, and without any bandage to retain them ; 
becaufe that will be wetted with urine, and gall 
the flcin. At firft I keep the patient very cool to 
prevent bleeding, and fometimes apply a rag dipt 
in cold water, to the wound, and to the genital 
parts, which I have found very ufeful in hot 

weather 



332 CUTTING FOR THE STONE. 

weather particularly. In children it is often alone 
fufficient to flop the bleeding, and always helpful 
in men. The day before the operation I give a 
purge to empty the guts, and never negledl to 
give fome laxative medicine or clyfter a few days 
after, if the belly is at all tenfe, or if they have 
not a natural ftool. What moved me to try this 
way, if I may be allowed to know my own 
thoughts, was the confideration of women fcarce 
ever dying of this operation, from which I con- 
cluded, that if I could cut into the urethra, beyond 
the corpora cavernofa urethras, the operation would 
be nearly as fafe in men as women. 

What fuccefs I have had in my private prac- 
tice I have kept no account of, becaufe I had no 
intention to publifli it, that not being fufficiently 
witnefled. Publickly in St. Thomas's hofpital I have 
cut two hundred and thirteen ; of the firft fifty 
only three died 5 of the fecond fifty, three; of the 
third fifty, eight; and of the laft fixty-three, fix. 
Several of thefe patients had the fmall pox during 
their cure, fome of which died, but I think not 
more in proportion than what ufually die of that dif- 
temper ; thefe are not reckon'd among thofe who 
died of the operation. The reafon why fo few 
died in the two firft fifdes was, at that time few 
very bad cafes ofFer'd ; in the third, the operation 
being in high requeft, even the moft aged and 
moft miferable cafes expefted to be fav'd by it ; 
befides, at that time, I made the operation 

lower 



CUTTING FOR THE STONE. 333 

lower in hopes of improving it, but found I 
was miftaken. But what is of moft confe- 
quence to be known is the ages of thofe who re- 
covered, and thofe who died. Of thefe, under 
ten years of age one hundred and five were cut, 
three died 5 between ten and twenty, fixty-two 
cut, foOr died 5 twenty and thirty, twelve cut, 
three died ; thirty and forty, ten cut, two died ; 
forty and fifty, ten cut, two died ; fifty 
and fixty, feven cut, four died ; fixty and feven- 
ty, five cut, one died; between feventy and 
eighty, two cut, one died. Of thofe who re- 
covered the three biggeft flones were § xii, x4, 
and viii, and the greateft number of ftones in any 
one perfon was thirty three. One of the three 
that died out of the hundred and five, was very 
ill with a whooping cough 3 another bled to death 
by an artery into the bladder, it being very hot 
weather at that time : But this accident taught 
me afterwards whenever a vefTel bled that I could 
not find, to dilate the wound with a knife, till I 
could fee it. Now if Jacqjjes or others who 
of late have been faid to have performed this 
operation, whether by defign or chance, did not 
take care to fecure the blood- veflels, which as 
yet has not been fuppofed, whatever their dexte- 
rity in operating might be, their fuccefs at leaft 
can be no fecret, for many of their children and 
moil of their men patients muft have bled to 
death. If I have any reputation in this way, 

I have 



334 CUTTING FOR THE STONE. 

I have earn'd it deraly, for no one ever endured 
more anxiety and ficknefs before an operation, yet 
from the time I began to operate, all uneafinefs 
ceafed 5 and if I have had better fuccefs than fome 
others, I do not impute it to more knowledge, 
but to the happinefs of a mind that was never 
ruffled or difconcerted, and a hand that never 
trembled during any operation. 



INDEX, 



I 

A 







DIPOSE membrane — '-^ 137 

its difeafes — 138 

Alantois — — — 280 

Amnion — — • — ^ -^ 278 

■ does its liquor ferve as nourifhment ? 
Amputation, how is the circulation kept up after it ? 

203 
» occafioned, and proving fatal from the cramp 

207 
— in mortifications ought to fucceed the fepara- 
tion — — . — — - 208 

Anafarca < — — — —a. 138 

Anchylofis^ how formed — •^ —.8 

Aneurifm — — — 187 

Animal body, what — _ .-,1 

■ its conftituent parts — 2 

Animals, why larger have flower pulfes, and lefs vi- 
gor in motion • — — — 20b 

■ ' why inadive ones require lefs food, and are 

not fo fuddeniy deftroyed by wounds — * 207 
Antra, Vide Smus ma>nll^ [up. 
Aorta,, frequently offified near the heart 182 

■ its valves covered with chalk — » ibid. 
» preternaturaily diilended — 182 
— — traced — . — igo 
Aqueous humour of the eye — ^ — 296 
Arm, right, why more u fed than the left 24 
Artery, coronary — -^ -^184 
carotids, why. rifing differently ibid. 

Y • Artery, 



INDEX. 

Artery, cervical — — iS6 

• fubclavian, axillary, &c. — . ibid. 

'^ — — intercoftal, &€. — — i88 

— -^ phrenic, &c. — -^ ibid. 

«— inguinal^ &c. — -^ i^o 

' — pulmonary ^— — 183 

Arteries, what »-=. »^ — 2 

' become bony — — — 5 

■ " ' — ' coats — ~-- 194, 200 

^*- — ~ the angles and laws of ramification 195 

^ — ' the force of their contractions 196 

' ■■ motion of the blood in them and in the veins 

199, &:c. 
j^racbnoides of ththram — — 221 

j^tlas, or frif vertebra — — 22 

Barrennefs of women — — . — 276 

Bile, in what quantity — ~» 1 64 

..- concreting forms ftones ««. — 166 

Biliary duds — — «- 163 

<■ .tm — — obftrudled ~ — ^ 166 

Bladder of urine - — —a ™ 260 

— — „ ■ feldom ulcerated — 261 

Bloodj quantity, celerity of its motion, &:c. 206 

*~« extravafated, requires firft purging, and then 

warm attenuants — ~ 208 

Blood-letting — ~ »— 89 

^ what artery in danger »- 187 

Bones, what — ^ — — 3 

— —- • fibres — — , 4, 9 

. how offify and grow — . — 4 

^ fometimes decreafe or wafte — 5 

«— — . why hollow — — 6 

« their place fupplied by fhells in fmall animals 7 

• broken, how united by the callus ibid. 

— — have not vifible lamelU — 9 

— their compad and fpungy fubftance ibid. 

T Boness 



IN D E X. 

Bones, diftorted or fradlured, cured by an indurating 
pafte --, ^37 

• their difeafes, particularly rm^J — 38 

—— of the cranium - — * 1 1 

■' trunk -— , — , 21 

— — upper limb -^ ^9 

*- ■ lower limb _ _ 34 

• ■ internal ear -^ — 307 

Bony excrefcences — —.5 

Brain — — 222 

— — full of water in lethargy — --, 224 

its ftate in an apoplexy — ibid. 

^ fcirrhous tumors in the cerebrum — 225 

• — ~ impofthumations of the cerebrum ibid, 

Breafl: and its cancer — — 14a 

decum^ or appendix vermiformis _ — 156 
Callus^ unites fradlured bones — 7 

Canalis arteriofus ^ — — 284 

Cancer — ^ _ 140 

Caries of bones — »^ — . ^a 

Carpus J bones of — — 22 

Cartilages, what — . — ^ 

' fubjed to olTification --. 5 

■ fwelled in rickets ibid. 

" prevent contiguous moveable bones from 

uniting — —^8 

■ eroded, occafion anchylofis ibid. 

. where placed, and ufe 41, &c. 

■■ moveable in the joint of the jaw 41 

femilunar in the knee _ 42 

Cartilago enftformis — — 28 

Caruncula lachrymalis — i 2qi 

Caruncula 7nyrtiformes »— —27^ 

— urethra — —5 268 

Caftration, how to fecure the veiTels 265 

Qat amenta •, .^ 275 

Y 2 • Catarad:. 



INDEX. 

Catara6!:, why does not the patient difcern objedls, 
though fenfible of light and colours 300 

Cerehellum — . — .— 223 

_ -— its wounds caufe fudden death -^ 224 
Cerebrum — — 222 

^ —» its wounds not mortal — 224 

Chorion — «« — 278 

Choroides oculi -— — . 293 

Circulation, the complete revolution 217 

*'■■ in fmall veiTels, and in living animals 204 

Clavicula — *-« — 29 

Clitoris -«- — 272 

Colon .— _ «-» 156 

Conception «- — 269, 276 

Conjun^iva oculi — — .291 

Cornea oculi ' — ■ — . ibid. 

— . . a great refractor of light 298 
Couching, not fo much refradion in the eye after the 

operation — . — . ibid. 

hiilory of a young gentleman 300 

Cowper, Mr. his operation on the antrum 19 

Cramp, occafioning firil amputation, and then death 

207 
Cranium^ why compofed of feveral bones 12 

Cryftalline humour — — 297 

_» — ^ ■ a lens for refradion 297, 298, 299 

Cuticula — — 134 

■ itsdifeafes — — ibid. 

Cutis — — 135 

— fmall painful tumors under it — i 136 
Cylification — •— ! 216 

Deafnefs caufed by redundant cerumen 305 

.. in fome cafes, perhaps, might be cured by 

^tr^oxditin^xhtmembrana tympani 306 

•— - — ■- in three cafes, probably, prevented by blifter- 

ing immediately after birth ibid, 

*-~-«* caufed by t\it polypus of the nofe compreffing 

the Euftachian tube 308 

Dentes, 



INDEX. 

Bmtes. Vide Teeth. 

Digeftion of the aliment — — 152, 216 

Diflocation of the thigh — — % 44 

* * » knee — 45 

Dropfy and tapping «. — « 211 

•— of the liver — - ■ 2 1 2 

• — true (^yr/Vfj never cured — 215 

■ in the dupUcature of the peritonaeum 1 48, 1 49 

Bu5ius arteriofus — — — 284 

— ' how clofed — 287 

• thoracicus ~ — 169 

venofus — — 283 



Duodenu. 



m — — ^- — 155 

Dura mater — — 218 

its finufes — • — 219 



ofTified — . 22 1 



319 



Ear, external — — 304 

— impofthumes of — — - 305 

— — membrana tympani — ibid. 

naturally perforated ibid, 
broke in a dog, without cauf- 
ing deafnefs ibid, 

deilroyed by ulcer, and the 
fmall bones thrown out, 
without deafnefs 306 

■ '■ ■ its perforation propofed ibid. 

■ fmall bones, with mufcles of the malleus 307 
— — Euftachian tube — . > — 308 
Ear, ftapes^ with its mufcle — — 309 

labyrinth — — ibid. 

Emphyfema ... — 138 

Epididymis — — '265 

Epiphyfis of bones — — 8 

Epigaftrium — — 134 

Eredion of the ^mi — — 269 

Excretory veffel — — 3 

Exfoliation of bones — — . 39, 40 

Extravafation. Vide Blood. 

Y3 Eye, 



I N D E X. 

Eye i— ^ _ _. 290 

-^ tunica conjunBiv a _ 291 

•■? ■ fderotis et cornea > — — ibid. 

— - iris^ prccejfus ciliares — ibid, 

— • tunica ch oroides *^ p— . 293 

-= huip.ors of ,— — 296 

*— - inflammations of, require immediate alTiflance 

' memhrana niElitans^ in amphibious animals, not 

for refradtion -r- ^^ 297 

Feelings the fenfe of «« — .. / ^ 1 1 

Females, why few£r born than males, i^;; 275 
Fibres, what > _ . ;, ■ -.— 2 
Fibula — . .,— • 36 

Figures of the Bones. 
' I. The fceleton of a child twenty months old, 7 

The thigh-bone of a m.an fawed through, ^ 50 

The OS hregmatis of Sifc&tus of fix months, ^ 

2. The head with the lower jaw 51 

3. A fe6lion of the fcuU and upper jaw 7 
The OS fphenoides ^52 
The infide of the bafe of the fcuil 3 

4. The trunk ^ — ^ — ^^ 

5. The vertehr^ _ ~ — 54 

6. Bones of the arm, fore-arm, and carpus g^ 

7. The hand . — ..., ^6 

8. The thigh and leg of the fceleton ^y 

9. The foot of the fceleton — 58 

10. The adult fceleton — —- 59 
Figures of the Mufcles. 

11. A mufcular bufto — «=- 122 

12. The fore view of a mufcular trunk 123 

13. The back view of the fame 124 

14. Two mufcular arms --- — • 125 

15. A mufcular arni and leg • — 126 
f6. Two mufcular legs »-- — 127 
5-7. A miifcolar hand -==' ^— 128 
■' ; ' ' ■ Figure? 



I N D E X 

Figures of the Miifcles. 

1 8. A mufcular foot — ■— 129 

ig, A complete mufcular figure — 130 

20. The mufcular figures of Hercules and Ant^us 

Figures of the Vifcera. 

21. Vifcera of the cibdonien and thorax infitu 249 

22. The liver, 'pancreas^ fpleen, and kidneys, with 
the large vefiels of the abdomen^ and contents of 
the -pelvis — ^ -^250 

23. The lafteals of the jejunum 7 
The origin and diftribution of the fupe-r>25i 

rior mefenteric artery 3 

24. A full view of the 'Z/'f;?^ _p^r^(^r^;;^ 252 

25. The ven^ hepatic a 7 
The biliary and pancreatic dufts \^SZ 

26. Receptaciilum chyli et du5lus thoracicus 254 

27. The fuperior and inferior cubital nerves ") 
Courfe and diftribution of humeral artery j" ^^^ 

2S. The parts concerned in V, S. hrachii 1 ^ 
A tumor extirpated from the cubital nerve \ ^^ 

29. T\iZ medulla fpinalis 7 
The intercoftal nerve ^'^Sl 

30. The animalcules f;^y^;;/z>/f \ 
The circulation in a fifh's tail I 

A fmall artery and a vein fpread on ar ^^ 
membrane j 

Figures of the Organs of Generation. 

31. The bladder, with proftate, veficul^ fe-\ 

minales ( 

A tranfverfe fedtion of the penis > 3 ^ ^ 

A longitudinal fe6lion of the penis j 

32. The female organs of generation 313 

33. The parts of two different hermaphrodites 314 
Figures of the Foetus. 

34. The heart, with its large veffels 9 
The heart, with the foramen ovale ^3^5 
The venal fyftem of the liver j^ 

Y 4 Figures 



INDEX. 

Figures of the Eye, and Cafes of Surgery, 
35. A diagram to iliuftrate vifion, and the' 

dark or infenfibie point of the eye 
26. The operation of imperforated iris 
The operation for froptojis corner 
A diagram, whence dimnefs of fight 

from an opacity of the cornea 
A diagram, whence the fenfe of light in 
a cataradous eye 
57. An offiiication in thtdura mater 

■ — in the heart 

Two exfoliations of both tables of ther ^ ^ 
fcull 
'38. Wood^ the miller -==- — 

39. The Biihcnocele performed on Heyjham 

40. Whitens exomphalos — — 
Fingers, bones of -- — 
Fifiula in ano — - — 72, 



Flea, why numerous joints in its legs . — 
Fluids, their proportion to the foiids — . — 
F(^tUs^ is it nourilhed by the mouth — 

■»=— ' receives red blood from the m.other — 
— circulation of its blood — — 

Foramen ovale — — — 

> »- ■ >- how clofed — — 

— — — not open in water-animals 

Fradure, how united by callus — — 

-■ "■ ... •. - how bound up with a pafte — . 

•— — - of the fcull -«. — 

Funis iimhilicalis — — 

Gallbladder — — 

Ganglion of nerves ~ — . 

Glands what «„ .^ — 

— — {lru6lure —-. — 

*— ■ ■ lym.phatic *— — 

•e-r — miliary — r- ? 

.^^-r— muciiaginousj of joints «-» 



INDEX. 

Gland, pineal — — 213,223 

—«— pituitary — — 213, 222 

— falivary — — 142 

■ ■ ■ *— . oeconomy — ■ — 145 

■ thymus — - — 213 

thyroide : — . — - ibid. 

Glandule renaies — —.263 

Gonorrhcea — — • _ 268 

Gutta ferena^ ftate of the brain and optic nerves 225 

Hemorrhage, why commonly on furfaces 202 
Haemorrhoides, how extirpated 158 
Hanging kills by interrupting refpiration 1 j6 
Heart, — — 177 
olTification of its mufcular fibres 5, 1 82, 319 

■ its bafis ulcerated, with pus mihQ pericar- 

dium 181 

. large, lax, and filled with pcl)pi in fatal dro- 

pfies — — ibid. 

.. its force — — — 196 

■ fyftole and diaftole^ why reciprocal 197 

■ ' throws the blood along the whole arterial t^- 

ftem — -^ — 200 
Hernia. Vide Rupture. 

• aqiAofa — — — 264 

Hydrocele «^ -^ »,. 263 

Hymen — — — — 273 

■ imperforated — — ibid, 
Hypochondrium — — *-• 134. 
Hypogafirium -^ .-^ .^ ^^ ibid. 

Jaundice — — : .^ 166 

Jaw, lower, not ofiified — -^—5 

Jejunum — . — 156 

Ileum intefiinum — —4 ibid. 

Iliac pallion — — 160 

Impofthumations, their feat — 139 

Injedion through the arteries into the veins 203 

Jnteftines — — ic^^ — i^Z 

^^ — — why fuch a length of *— 156 

Joint 



INDEX. 

Joint of the thigh impoflhu mated 29 

— difeafes of, — . — — : 48 
Ms — — — i 291 

— afls as a fphinder mufcle r^ 292 

Kidneys — ~— — , 259 

•— — -^ tul'uli^ papillcs, glands^ znd pelvis 260 

«■ ■ one frequently almofl: confumed 272 

* fometimes but one — - ibid. 

Labia pudendi _ — 272 

Labour, child-bearing, why at the ufual time 289 

Ladeals — — . _« 168 

Ligament, what — — 3 
— — — where placed, and ufes 43, &c. 

Ugamentum uteri rotundum — . — 274 

* "" ' ■— — — latum — — ibid. 

Lithotomy, an account of — 325 

Liver — — — 161 
*— ^ difeafed -^ —,165 

■ " dropfical -»« — 212 

Lobfler, its fhells and joints — - 7 

Lungs — — — 172 

Luxations of the fpine moll commonly at the lower 

dorfal vertebra — — . — - 26 
Lymphseduds '— — 2, 206 

Males, why more born than females 275 

Mammae — — _ .»« 139 

- ^ y ' cancerous ~ — — - — 140 

Marrow, oily =™, -»». — 5 

»- bloody „ „ ^^ _ ibid. 

-— — cells, velicles, 6cc. — — - 6 

Maxillary gland, — — «— 143 

•~ — — fcirrhous, proving fatal in nine weeks 

ibid. 

Mediaftinum ~ — -«« «-« 172 

Medulla oblonzata — — — »— 224 

wounded, caufes fudden death ibid, 

fpinalis -** •— ' *— ibid. 

Memhana 



I N D E X. 

Memhrana oblongata its wounds •— 224 

Membrana adipofa -— . ^— — 137 

...^ -. its difeafes — — 13B 

" ' ■ tympani. Vide Ear. 

■ ni5iitans. Vide Eye. 

Membrane, what — — 2, 61 

— containing, in veiling, &c. — — . 141 

Mefentery — — ~ — — 160 
Metacarpus^ bones of — — — 33 

Metatarfus^ bones of -— — — 37 

Miller, hiitory of the lofs of his arm 321 

Mons Veneris • — — — — 272 

Mortification, Ihould feparate, before we amputate 208 
Mufcles, what — — — — 3 

^ their fibres fuppofed veficular — _ 62 

.^ ^ redlilineal, pennaeform, ufe 62, &c. 

- of the abdomen — — — 6y 

' of the genitals and anus — — 69 

• -^ of the fcalp, ear, eye, lips, and nofe 72 

-■ of the OS hyoides, tongue, larynx^ pharynx^ 

and uvula — — — 78 

• — • ' of the lower jaw — — 82 

— ~ of tht clavicula znd fcapula — —83 

-^ . of the OS humeri — — ^^ 

^ — „ of the fore arm and hand — ^^ 

- ' of the head and neck — — 97 

'■ of refpiration, fpine, and />^/w 102 

— - — of the thigh and leg — . — 108 



•— — " of the foot and toes — — 115 

*- — of the ojficula auditus — 3075 309 

Nephrotomy, what pafTes for that operation 260 

Nerves, what — — 225, 246, 2 

. ganglions — — 227, 247 

inftruments of fenfation and of motion ibid, 

•—— whether vibrating cords or tradudory tubes 

228, 247 
*« — feem to decuffate — — 294 

— the order of diifedting them — - 24a 

prr-* of incephalon and medulla fpinalis 229 

Nerves, 



INDEX, 

Nei'ves, firft pair — — 230 

»- — ..> fecond pair -— *— 231 

probably decuffate '-^ 294 

third pair — •— — 231 

fourth -— -—223 



fifth 
fixth 



232 
235 



•-- — feventh — — 236 

m eighth •>* — -— ibid. 

"'■ tenth — — — ibid. 

— ' ■ of the medulla fpinalis — ^ 240 

I**— firll cei vical — — 240 

»— fecond ~- -— — 241 

— « fourth, fifth, fixth, and feventh cervical, with 

the firll dorfal •— 242 

i^"^'"- the twelve dorfal ■ — — 244 

• ' the By^ lumbar -*- ibid. 

•- — the facral ;— -^ — 245 
Nicholls, Dr. his opinion of the fpenoidal finufes 14 

Nymph ^g ^^, *— .. -— 272 

CEfophagus — ' — 150 

Omentum — — — 149 

Os tinea — — —.274 

Os £thmoUes — -; ~ 13 

r— coccygis — — «— 22, 25 

r— femoris «— — — . — 34 

'»— frontis «— ~ -^ 12 

— humeri •^^. »« -^ 31 

•— innominatum — — 28 

^ maxilla infer tor is — ~ — 20 

~ n ^ ■ fuperioris —» «— 18 

& nqfi — ^ — — ly 

*^ cccipitis «^ ^ — « 16 



INDEX. 

Os petrofum -«i — ^ 35 

— planum — — • -^ i8 

— facrum — — 22^ 25 
— • fphenoides — — 13 

— fpongiofum —« — — 20 

— temporis — — — - -^ 15 

— vomer — -— —- 20 
O^ trifiuetra — - — — 8, 1 1 
OJficula audit us — — — 3^7 
OiTificsLtion'mtht dura mater — -^ 319 

____ — heart — — ibid. 

Offifying matter, deficient in a lower jaw, and in the 

rickets — ^- — 5 

Ovaria — -^ — * 274 

Pancreas — _ — 1% 

Paracentefis — . — - ~ lii 

Parotis, gland, — , — _— 142 

■ gland, its du6l wounded — • 143 

■ ' " ulcerated _ — « ibid. 
Patella — — — ^5, 

how united v/hen broken — . ibid. 

Penis — — — 267 

Pericardium — — •«-* 177 

— containing ^//j — — 18 r 

"■ adhering to the heart — ibid. 

Pericranium . — «— . — 10 

Periofteum _ _ — ibid. 

^— tliickened in rickets — . 5 

Peritoneum _ — - —.148 

Pia mater — — — 221 

— .= olTihed «»,.-«.». ibid. 

Placenta — «- .-, 281 

i- its vefTels anaftomofe with thofe of the uterus 282 

Pleura — - — ., — 172 

Pleuritic pains, why more commonly in the left fide 

17S 
P(9/y^/^j of blood — ™ «—; 2ia 

Pope's eye, in brutes ^ — — -— 214 

PrQcejjfus 



INDEX. 

Procerus ciliares — — 292 

Procidentia ani -— .. — ^ •— 157 

Pro§fat^e — — — 266 

— -. difeafed — • — ibid. 

Pupilla — . — . — 291 

-,hpw contradled and opened 292 

. * why round and oval in different animals ib. 

Radius — • — . *— 32 

Receptaculum chyli — -» 168 

Return inteftinum ■ — — . — 157 

Regio umbilicalis — - — 133 
Refpiration, motions — — 104, &c. 

ufe — . _ .— 173 

Reticulum mucofum — ~ 135 
Retina .^ «-, -^ — 293 
Ribs, fractured or diftorted by carelefs nurfes 27 
Rupture of matter, and probably of the gut, under 
Fallopius^s ligament — 47 
— — - of matter, and of blood and matter into the 
fore part of the thigh — 190 
•— of water — — - — — . 264 
■ * cafe of Heyfham — . — 322 
. White — — . 324 

Sanguification — — -^ 217 

Sckrotis tunica oculi — — 291 

Scapula — — — — 27 

Scarifications, when hurtful — 208 

Scrobiculus cordis — — — 133 

Scurvy, how affeds the cuticula 134 
Scull. Vide Cranium. 

' fradlured — - ^— — 319 

Secretion, how performed — — 147 

Seed, the nature of its animalcules — 269 

^ella turcica — — — 13 

^inus^ frontal — — — ibid. 

of the OS fphenoides — 14 

of the maxillary bone — — • 19 

_ _._ — fometimes impofthumated ib. 

Skin 



I N D E X. 

Skin ~ ~ — 135 

Smelling, the fenfe of — «« 310 

Solids, their proportion to fluids — — - 2c6 

Spine, bones of _ — - — 21 

why compofed of fo many bones 22 

final caufes of its different curvatures 23 

Spleen — _ — —.167 
Sternum — — . — 27 
Stomach — -«- —.151 
Stones, extraded from the loins — 260 
Stone, fymptoms of, equivocal — 261 
■ ' account of the operation — ■ — 325 
Sublingual gland — — 143 
Suppreffion of urine, in the kidneys and in the blad- 
der, different — — . 262 

how to be treated — -^ ibid. 

Sutures, how formed, — — 8 

what — — — If 

— . particular ones — . — ibid. 

Tapping for the dropfy — — 2 1 1 
'Tarfus^ bones of — _ —.36 

Tailing, the fenfe of — — 311 

Teeth — , — ^ «^ _ 20 

Ihed — — — 21 

Tendons, what — — 3 

pricked in bleeding — ..^ ^^ 

defies — — _ 263 

Thymus^ gland -. — , 213 

Ton/ill^ ^ glandul(e -^ — 14^ 

how extirpated — _ ibid* 



Tooth-ach, its feat — . 21 

Trepan, not applicable at frontal finus 13 

Tuh^ Fallopian^ — _ w- ' 275 

Tumors, fmall ones under the fKin giving exquifite 

pain _ _ «, 136 

Vaginsi — .-» .«, 273 

Vafa defer entia — - ««, — 266 

Vein, what -«. „^ . .^ 2 

Vein 



INDEX, 

Vein coats — . — "^ 194? 205 

> .- why curved in its courfe 194 

. why cutaneous on the arm ^^ 1^2 

. — ^— . cava, with its branches — 191 

cephalic, how avoided in cutting ifiues 192 

> — ' — port arum — . — 193 

I. .1 . — — — in the fcstus — 283 

— — pulmonary — — 183 

Venee laSiea — — - — 168 

Vertebra _ — •— 21 

I their claffes *-mm ««. 22 

;; ^-.— bodies, proceffes, — 23 

— —«- fupernumerary — — ' 28 

Vejicula feminaks — — i— 266 

Vifion, the Retina the organ or — 294 

— __ caufed by an impulfe on the retina 972 

»«_. how carried on after couching 298 

.^..^ why do objefe appear f ngle - — 295 

— — > — why do not objefe appear inverted 297 

i.i,u obfervations from a young gentleman, who 

never faw till couched -— — 300 

Vitreous humor — — 299 

Ulna — . *— •— 31 

Ureters — — ^ — 260 

* diftended in calculous patients 271 

Urethra — — . — 268 

— > , ,., its glands »«, _ ibid. 

—I ftridlures — — ibid. 

— — — in women — -— 273 

Urine, pafTes only by the ureters — 262 

Uterus — — — • '^7Z 

White fwelling « -■ ~ 48 



FINIS. 



^ 



4D 



^ COUNT WAY LIBRARY OF MEDICINE 

:: : QM 

5: 21 

1750 

RARE BOOKS DEPARTMENT